Prevalence, attributes, and outcomes of fitness and frailty in community-dwelling older adults: report from the Canadian study of health and aging
Abstract
BACKGROUND: Frailty and fitness are important attributes of older persons, but population samples of their prevalence, attributes, and outcomes are limited. METHODS: The authors report data from the community-dwelling sample (n = 9008) of the Canadian Study of Health and Aging, a representative, 5-year prospective cohort study. Fitness and frailty were determined by self-reported exercise and function level and testing of cognition. RESULTS: Among the community-dwelling elderly population, 171 per 1000 were very fit and 12 per 1000 were very frail. Frailty increased with age, so that by age 85 years and older, 44 per 1000 were very frail. The risk for adverse health outcomes increased markedly with frailty: Compared with older adults who exercise, those who were moderately or severely frail had a relative risk for institutionalization of 8.6 (95% confidence interval, 4.9 to 15.2) and for death of 7.3 (95% confidence interval, 4.7 to 11.4). These risks persist after adjustments for age, sex, comorbid conditions, and poor self-rated health. At all ages, men reported higher levels of exercise and less frailty compared with women. Decreased fitness and increased frailty were also associated with poor self-ratings of health (42% in the most frail vs 7% in the most fit), more comorbid illnesses (6 vs 3), and more social isolation (34% vs 29%). CONCLUSIONS: Fitness and frailty form a continuum and predict survival. Exercise influences survival, even in old age. Relative fitness and frailty can be determined quickly in a clinical setting, are potentially useful markers of the risk for adverse health outcomes, and add value to traditional medical assessments that focus on diagnoses.
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In the CHS population, the combination of frailty, disability and comorbidity was present in 21.5%.
“the combination of frailty, disability and comorbidity was present in 21.5% of the study group.”
From Frailty in elderly people (2013) · cites this paper as [96]
In the CHS population, frailty was present without comorbidity or disability in 26.6%.
“frailty was present without comorbidity or disability in 26.6% of the study group.”
From Frailty in elderly people (2013) · cites this paper as [96]
In the CHS population, frailty and disability were present in 5.7%.
“frailty and disability (defined as the presence of restriction in at least one activity of daily living) was present in 5.7%”
From Frailty in elderly people (2013) · cites this paper as [96]
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- Authors
- Rockwood, K., Howlett, S. E., MacKnight, C., Beattie, B. L., Bergman, H., Hébert, R., Hogan, D. B., Wolfson, C., & McDowell, I.
- Affiliations
- Dalhousie University (CA)
- Corresponding author
- Rockwood, Kenneth
- ORCID
- Venue
- The Journals of Gerontology: Series A
- Publisher
- Oxford University Press (OUP)
- Published
- 2004-12
- Volume
- 59
- Issue
- 12
- Pages
- 1310-1317
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- OpenAlex
- W2145598786
- Cited by
- 608
- References
- 57
- Citations by year
- 2026: 12 · 2025: 22 · 2024: 36 · 2023: 40 · 2022: 29 · 2021: 35 · 2020: 45 · 2019: 61 · 2018: 51 · 2017: 31 · 2016: 41 · 2015: 42 · 2014: 22 · 2013: 28 · 2012: 19
- FWCI
- 3.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journals of Gerontology Series A (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- frailty, physical fitness, community-dwelling older adults, physical activity, institutionalization, mortality, self-rated health, comorbidities, social isolation, sex differences, Canadian Study of Health and Aging
- MeSH terms
- Aged, Aged, 80 and over, Canada, Female, Humans, Male, Physical Fitness, Prospective Studies, Cohort Studies, Prevalence, Frail Elderly
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