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The Relationship Between Intervening Hospitalizations and Transitions Between Frailty States
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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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“Deconditioning is also relevant when older adults are hospitalized, ill, or temporarily immobilized, thereby disrupting their PA [266,267].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [266]
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“Deconditioning is also relevant when older adults are hospitalized, ill, or temporarily immobilized, thereby disrupting their PA [266,267].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [266]
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Cites
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975) · Journal of Psychiatric Research · doi:10.1016/0022-3956(75)90026-6 · Cited by 88,282
The Measurement of Observer Agreement for Categorical Data
Landis, J. R., & Koch, G. G. (1977) · Biometrics · doi:10.2307/2529310 · Cited by 81,148
Frailty in Older Adults: Evidence for a Phenotype
Fried, L. P., Tangen, C. M., Walston, J., Newman, A. B., Hirsch, C., Gottdiener, J., Seeman, T., Tracy, R., Kop, W. J., Burke, G., et al. (2001) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/56.3.m146 · Cited by 24,907
Fried, L. P., Ferrucci, L., Darer, J., Williamson, J. D., & Anderson, G. (2004) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/59.3.m255 · Cited by 4,032
The physical activity scale for the elderly (PASE): Development and evaluation
Washburn, R. A., Smith, K. W., Jette, A. M., & Janney, C. A. (1993) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(93)90053-4 · Cited by 3,256
The Robust Inference for the Cox Proportional Hazards Model
Lin, D. Y., & Wei, L. J. (1989) · Journal of the American Statistical Association · doi:10.1080/01621459.1989.10478874 · Cited by 2,695
Survival analysis using the SAS system : a practical guide
Allison, P. D. (1995) · Medical Entomology and Zoology · Cited by 2,402
Inouye, S. K. (2006) · New England Journal of Medicine · doi:10.1056/nejmra052321 · Cited by 2,091
The Frailty Syndrome: Definition and Natural History
Xue, Q. (2010) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2010.08.009 · Cited by 2,067
The Care Transitions Intervention: Results of a Randomized Controlled Trial
Coleman, E. A., Parry, C., Chalmers, S., & Min, S.-J. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.17.1822 · Cited by 1,937
Walston, J., Hadley, E. C., Ferrucci, L., Guralnik, J. M., Newman, A. B., Studenski, S. A., Ershler, W. B., Harris, T., & Fried, L. P. (2006) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2006.00745.x · Cited by 1,605
Hazards of Hospitalization of the Elderly
Creditor, M. C. (1993) · Annals of Internal Medicine · doi:10.7326/0003-4819-118-3-199302010-00011 · Cited by 1,409
Phenotype of frailty: characterization in the women's health and aging studies
Bandeen-Roche, K., Xue, Q.-L., Ferrucci, L., Walston, J., Guralnik, J. M., Chaves, P., Zeger, S. L., & Fried, L. P. (2006) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/61.3.262 · Cited by 1,215
Transitions between frailty states among community-living older persons
Gill, T. M., Gahbauer, E. A., Allore, H. G., & Han, L. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.4.418 · Cited by 1,141 · cited 4×
“Indeed, increasing evidence indicates that transitions from states of greater frailty to lesser frailty are not uncommon (5,6), meaning that many older persons have the capacity to recover from frailty and prefrailty, respectively.”
BackgroundMethodInfluentialSelf-citationFugate Woods, N., LaCroix, A. Z., Gray, S. L., Aragaki, A., Cochrane, B. B., Brunner, R. L., Masaki, K., Murray, A., & Newman, A. B. (2005) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2005.53405.x · Cited by 1,040
ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES
Abramson, J. S., Pickering, L., Gilsdorf, J. R., Dunne, E. M., Lawson, H. W., Dubin, G. O., Barr, E., Chesson, H. W., Garnett, G. P., & Markowitz, L. E. (2006) · Cited by 932
A program to prevent functional decline in physically frail, elderly persons who live at home
Gill, T. M., Baker, D. I., Gottschalk, M., Peduzzi, P. N., Allore, H., & Byers, A. (2002) · New England Journal of Medicine · doi:10.1056/nejmoa020423 · Cited by 871
Self-citationLandefeld, C. S., Palmer, R. M., Kresevic, D. M., Fortinsky, R. H., & Kowal, J. (1995) · New England Journal of Medicine · doi:10.1056/nejm199505183322006 · Cited by 825
The LIFE Study Investigators* [*See Appendix for List of LIFE Study Investigators] (2006) · The Journals of Gerontology Series A · doi:10.1093/gerona/61.11.1157 · Cited by 668
Hospitalization, Restricted Activity, and the Development of Disability Among Older Persons
Gill, T. M. (2004) · JAMA · doi:10.1001/jama.292.17.2115 · Cited by 623
Self-citationFried, L. P., Xue, Q.-L., Cappola, A. R., Ferrucci, L., Chaves, P., Varadhan, R., Guralnik, J. M., Leng, S. X., Semba, R. D., Walston, J. D., et al. (2009) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/glp076 · Cited by 539
Change in Disability After Hospitalization or Restricted Activity in Older Persons
Gill, T. M., Allore, H. G., Gahbauer, E. A., & Murphy, T. E. (2010) · JAMA · doi:10.1001/jama.2010.1568 · Cited by 532
Self-citationEhlenbach, W. J. (2010) · JAMA · doi:10.1001/jama.2010.167 · Cited by 522
Xue, Q., Bandeen‐Roche, K., Varadhan, R., Zhou, J., & Fried, L. P. (2008) · The Journals of Gerontology Series A · doi:10.1093/gerona/63.9.984 · Cited by 490
Frailty: An Emerging Geriatric Syndrome
Ahmed, N. N., Mandel, R., & Fain, M. J. (2007) · The American Journal of Medicine · doi:10.1016/j.amjmed.2006.10.018 · Cited by 461
Antecedents of Frailty Over Three Decades in an Older Cohort
Strawbridge, W. J., Shema, S. J., Balfour, J. L., Higby, H. R., & Kaplan, G. A. (1998) · The Journals of Gerontology Series B · doi:10.1093/geronb/53b.1.s9 · Cited by 453
Toward an Understanding of Frailty
Hamerman, D. (1999) · Annals of Internal Medicine · doi:10.7326/0003-4819-130-11-199906010-00022 · Cited by 446
Priority Areas for National Action
Institute of Medicine (2003) · National Academies Press eBooks · doi:10.17226/10593 · Cited by 434
Prognostic significance of potential frailty criteria
Rothman, M. D., Leo‐Summers, L., & Gill, T. M. (2008) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2008.02008.x · Cited by 428 · cited 1×
“These modified criteria have strong predictive validity (19).”
BackgroundSelf-citationFrailty, hospitalization, and progression of disability in a cohort of disabled older women
Boyd, C. M., Xue, Q., Simpson, C. F., Guralnik, J. M., & Fried, L. P. (2005) · The American Journal of Medicine · doi:10.1016/j.amjmed.2005.01.062 · Cited by 402
Peterson, M. J., Giuliani, C. A., Morey, M. C., Pieper, C. F., Evenson, K. R., Mercer, V. S., Cohen, H. J., Visser, M., Brach, J. S., Kritchevsky, S. B., et al. (2009) · The Journals of Gerontology Series A · doi:10.1093/gerona/gln001 · Cited by 388
Recovery From Disability Among Community-Dwelling Older Persons
Hardy, S. E. (2004) · JAMA · doi:10.1001/jama.291.13.1596 · Cited by 365
Gill, T. M., Desai, M. M., Gahbauer, E. A., Holford, T. R., & Williams, C. S. (2001) · Annals of Internal Medicine · doi:10.7326/0003-4819-135-5-200109040-00007 · Cited by 306
Self-citationRecommended Adult Immunization Schedule: United States, 2012
Advisory Committee on Immunization Practices† (2012) · Annals of Internal Medicine · doi:10.7326/0003-4819-156-3-201202070-00388 · Cited by 302
Frailty and Its Definition: A Worthy Challenge
Rockwood, K. J. (2005) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2005.53312.x · Cited by 288
Ferrucci, L. (1997) · JAMA · doi:10.1001/jama.1997.03540330050034 · Cited by 281
Effect of Dissemination of Evidence in Reducing Injuries from Falls
Tinetti, M. E., Baker, D. I., King, M., Gottschalk, M., Murphy, T. E., Acampora, D., Carlin, B. P., Leo-Summers, L. S., & Allore, H. G. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0801748 · Cited by 257
Self-citationOnset of Frailty in Older Adults and the Protective Role of Positive Affect.
Ostir, G. V., Ottenbacher, K. J., & Markides, K. S. (2004) · Psychology and Aging · doi:10.1037/0882-7974.19.3.402 · Cited by 203
Underestimation of Disability in Community‐Living Older Persons
Gill, T. M., Hardy, S. E., & Williams, C. S. (2002) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.2002.50403.x · Cited by 182
Self-citationBoyd, C. M., Xue, Q., Guralnik, J. M., & Fried, L. P. (2005) · The Journals of Gerontology Series A · doi:10.1093/gerona/60.7.888 · Cited by 122
Gill, T. M., Allore, H. G., Holford, T. R., & Guo, Z. (2004) · The American Journal of Medicine · doi:10.1016/j.amjmed.2004.05.018 · Cited by 101
Self-citationSands, L. P., Yaffe, K. S., Lui, L., Stewart, A., Eng, C., & Covinsky, K. E. (2002) · The Journals of Gerontology Series A · doi:10.1093/gerona/57.7.m449 · Cited by 66
Subtypes of Disability in Older Persons over the Course of Nearly 8 Years
Gill, T. M., Guo, Z., & Allore, H. G. (2008) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2007.01603.x · Cited by 61
Self-citationRecommended Adult Immunization Schedule: United States, 2010*
Advisory Committee on Immunization Practices† (2010) · Annals of Internal Medicine · doi:10.7326/0003-4819-152-1-201001050-00008 · Cited by 52
The Effect of Undernutrition in the Development of Frailty in Older Persons
Bischoff, H. A., Staehelin, H. B., & Willett, W. C. (2006) · The Journals of Gerontology Series A · doi:10.1093/gerona/61.6.585 · Cited by 19
A Semiparametric Transition Model with Latent Traits for Longitudinal Multistate Data
Lin, H., Guo, Z., Peduzzi, P. N., Gill, T. M., & Allore, H. G. (2008) · Biometrics · doi:10.1111/j.1541-0420.2008.01011.x · Cited by 12
Self-citation
Research works printed but not linked: 4
- Gill, 2006, Archives of Internal Medicine, 166, 418, 10.1001/.418 · DOI · Paper page
- 2001, The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56A, M146
- 2002, The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 57A, M449
- 2009, The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 64, 1049
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Schouten, H. J., Geersing, G., Koek, H. L., Zuithoff, N. P. A., Janssen, K. J. M., Douma, R. A., van Delden, J. J. M., Moons, K. G. M., & Reitsma, J. B. (2013) · BMJ · doi:10.1136/bmj.f2492 · Cited by 346
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Lee, J. S. W., Auyeung, T., Leung, J. C. S., Kwok, T. C. Y., & Woo, J. (2014) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2013.12.002 · Cited by 323
Izquierdo, M., de Souto Barreto, P., Arai, H., Bischoff-Ferrari, H. A., Cadore, E. L., Cesari, M., Chen, L.-K., Coen, P. M., Courneya, K. S., Duque, G., et al. (2025) · The Journal of nutrition, health and aging · doi:10.1016/j.jnha.2024.100401 · Cited by 273
Multisystem physiological perspective of human frailty and its modulation by physical activity
Taylor, J. A., Greenhaff, P. L., Bartlett, D. B., Jackson, T., Duggal, N. A., & Lord, J. M. (2022) · Physiological Reviews · doi:10.1152/physrev.00037.2021 · Cited by 218
Metadata
- Authors
- Gill, T. M., Gahbauer, E. A., Han, L., & Allore, H. G.
- Affiliations
- Yale University (US)
- 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
- 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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