Cited by 142Frailty in Older AdultsNutrition and Health in AgingPharmaceutical Practices and Patient Outcomes

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The Relationship Between Intervening Hospitalizations and Transitions Between Frailty States

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Gill, T. M., Gahbauer, E. A., Han, L., Allore, H. G.·2011·The Journals of Gerontology Series A: Biological Sciences and Medical Sciences

DOI 10.1093/gerona/glr142PMC PMC3193526

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Abstract

BACKGROUND: Frailty among older persons is a dynamic process, characterized by frequent transitions between frailty states over time. We performed a prospective longitudinal study to evaluate the relationship between intervening hospitalizations and these transitions. METHODS: We studied 754 nondisabled community-living persons, aged 70 years or older. Frailty, assessed every 18 months for 108 months, was defined on the basis of muscle weakness, exhaustion, low physical activity, shrinking, and slow walking speed. Participants were classified as frail if they met three or more of these criteria, prefrail if they met one or two of the criteria, or nonfrail if they met none of the criteria. Hospitalizations were ascertained every month for a median of 108 months. RESULTS: The exposure rates (95% confidence interval) of hospitalization per 1,000 months, based on frailty status at the start of each 18-month interval, were 19.7 (16.2-24.0) nonfrail, 32.9 (29.8-36.2) prefrail, and 57.2 (52.9-63.1) frail. The likelihood of transitioning from states of greater frailty to lesser frailty (ie, recovering) was consistently lower based on exposure to intervening hospitalizations, with adjusted hazard ratios per each hospitalization ranging from 0.46 (95% confidence interval: 0.21-1.03) for the transition from frail to nonfrail states to 0.52 (95% confidence interval: 0.42-0.65) for the transition from prefrail to nonfrail states. Hospitalization had more modest and less consistent effects on transitions from states of lesser frailty to greater frailty. Nonetheless, transitions from nonfrail to frail states were uncommon in the absence of a hospitalization. CONCLUSIONS: Recovery from prefrail and frail states is substantially diminished by intervening hospitalizations. These results provide additional evidence highlighting the adverse consequences of hospitalization in older persons.

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2009, The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 64, 1049

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Authors: Gill, T. M., Gahbauer, E. A., Han, L., & Allore, H. G.
Affiliations: Yale University (US)
ORCID: Gill, T. M.
Han, L.
Allore, H. G.
Venue: The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
Publisher: Oxford University Press (OUP)
Published: 2011-08-17
Volume: 66A
Issue: 11
Pages: 1238-1243
ISSN: 1079-5006 (ISSN-L)
1758-535X
DOI: 10.1093/gerona/glr142
PMC: PMC3193526
OpenAlex: W2112937554
Cited by: 142
References: 47
Citations by year: 2026: 4 · 2025: 9 · 2024: 7 · 2023: 8 · 2022: 14 · 2021: 7 · 2020: 12 · 2019: 11 · 2018: 14 · 2017: 8 · 2016: 5 · 2015: 14 · 2014: 11 · 2013: 11 · 2012: 7
FWCI: 4.42
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: The Journals of Gerontology Series A (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute on Aging (R37AG017560, K24AG021507, R37AG17560, P30 AG21342, P30AG021342)
Topics: Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
Keywords: frailty, pre-frailty, hospitalization, frailty transitions, older adults, community-dwelling older adults, Fried frailty phenotype
MeSH terms: Aged, Aged, 80 and over, Female, Health Status, Hospitalization, Humans, Male, Prospective Studies, Frail Elderly

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The Relationship Between Intervening Hospitalizations and Transitions Between Frailty States

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