Frailty: Emergence and Consequences in Women Aged 65 and Older in the Women's Health Initiative Observational Study
Open accessAbstract
Objectives: To define frailty using simple indicators; to identify risk factors for frailty as targets for prevention; and to investigate the predictive validity of this frailty classification for death, hospitalization, hip fracture, and activity of daily living (ADL) disability. Design: Prospective study, the Women's Health Initiative Observational Study. Setting: Forty U.S. clinical centers. Participants: Forty thousand six hundred fifty‐seven women aged 65 to 79 at baseline. Measurements: Components of frailty included self‐reported muscle weakness/impaired walking, exhaustion, low physical activity, and unintended weight loss between baseline and 3 years of follow‐up. Death, hip fractures, ADL disability, and hospitalizations were ascertained during an average of 5.9 years of follow‐up. Results: Baseline frailty was classified in 16.3% of participants, and incident frailty at 3‐years was 14.8%. Older age, chronic conditions, smoking, and depressive symptom score were positively associated with incident frailty, whereas income, moderate alcohol use, living alone, and self‐reported health were inversely associated. Being underweight, overweight, or obese all carried significantly higher risk of frailty than normal weight. Baseline frailty independently predicted risk of death (hazard ratio (HR)=1.71, 95% confidence interval (CI)=1.48–1.97), hip fracture (HR=1.57, 95% CI=1.11–2.20), ADL disability (odds ratio (OR)=3.15, 95% CI=2.47–4.02), and hospitalizations (OR=1.95, 95% CI=1.72–2.22) after adjustment for demographic characteristics, health behaviors, disability, and comorbid conditions. Conclusion: These results support the robustness of the concept of frailty as a geriatric syndrome that predicts several poor outcomes in older women. Underweight, obesity, smoking, and depressive symptoms are strongly associated with the development of frailty and represent important targets for prevention.
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Strong evidence from multiple large observational studies indicates that CVD is a risk factor for frailty and that frail patients are more likely to develop CVD than non-frail individuals.
“Strong evidence from multiple, large, observational studies indicates that the presence of CVD is a risk factor for frailty and that patients with frailty are more likely to develop CVD than those who are not frail”
From Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty (2018) · cites this paper as [201]
Longitudinal investigations have shown that depression predicts future frailty.
“longitudinal investigations have shown that depression predicts future frailty (Fried, Tangen, Walston, Newman, Hirsch, Gottdiener, Seeman, Tracy, Kop, Burke, and McBurnie 2001;Woods, LaCroix, Gray, Aragaki, Cochrane, Brunner, Masaki, Murray, and Newman 2005)”
From Successful aging: Advancing the science of physical independence in older adults (2015) · cites this paper as Woods et al. 2005
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- Authors
- Fugate Woods, N., LaCroix, A. Z., Gray, S. L., Aragaki, A., Cochrane, B. B., Brunner, R. L., Masaki, K., Murray, A., & Newman, A. B.
- Affiliations
- University of Hawaiʻi at Mānoa (US)
- ORCID
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2005-07-25
- Volume
- 53
- Issue
- 8
- Pages
- 1321-1330
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- OpenAlex
- W1576645826
- Cited by
- 1,040
- References
- 23
- Citations by year
- 2026: 18 · 2025: 33 · 2024: 49 · 2023: 40 · 2022: 69 · 2021: 74 · 2020: 50 · 2019: 52 · 2018: 61 · 2017: 82 · 2016: 71 · 2015: 69 · 2014: 57 · 2013: 70 · 2012: 53
- FWCI
- 10.25
- Type
- journal article
- Language
- en
- Open access
- green
- escholarship.org
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- frailty, older women, frailty risk factors, frailty classification, mortality, hip fracture, activities of daily living disability, hospitalization, underweight, obesity, smoking, depressive symptoms, physical activity, muscle weakness, Women's Health Initiative Observational Study
- MeSH terms
- Activities of Daily Living, Aged, Chronic Disease, Depression, Female, Follow-Up Studies, Hip Fractures, Hospitalization, Humans, Obesity, Prospective Studies, Risk Factors, Smoking, Weight Loss, Walking, Frail Elderly, Outcome Assessment, Health Care
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