Frailty Trajectories and Mortality Risk in Community-dwelling Older Adults: a 9-year Follow-up Study

Overview

Journal Eur Geriatr Med

Specialty Geriatrics

Date 2025 Mar 11

PMID 40067557

Authors

Gabriela Cabett Cipolli

Daniela de Assumpcao

Ivan Aprahamian

Mallak Khalid Alzahrani

Ligiana Pires Corona

Yeda Aparecida de Oliveira Duarte

Monica Sanches Yassuda

Qian-Li Xue

Affiliations

Soon will be listed here.

Abstract

Purpose: Frailty is a well-established risk factor for adverse health outcomes, yet its dynamic nature and predictors remain partially understood. This study aimed to investigate factors influencing frailty transitions and mortality risk among community-dwelling older adults.

Methods: We conducted a longitudinal study using a 9-year follow-up data from the Health, Well-being, and Aging Study (SABE, as known in Portuguese). A Markov model, fitted via multinomial logistic regression, identified factors independently associated with frailty transitions between waves. Four trajectory groups were identified: stable, worsening, improving, and fluctuating.

Results: A total of 1399 individuals aged 60 and older (61.8% female) were enrolled, with a mean age of 73.9 (SD ± 9.2) years. Among frailty transitions, 37.8% remained stable, 56.4% worsened, 1.3% improved, and 4.4% fluctuated. After adjusting for baseline variables, we found that older age, cognitive impairment, multimorbidity, and depressive symptoms were significantly linked to a higher risk of being frail at the next visit. The mortality risk was associated with male sex, older age, frailty, cognitive impairment, and multimorbidity.

Conclusion: Sociodemographic and health-related factors contribute to increased risk of experiencing frailty and mortality among community-dwelling older adults. Further research is needed to identify modifiable factors influencing frailty transitions.

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