Transitional status and modifiable risk of frailty in Japanese older adults: A prospective cohort study.

Aim: The purpose of the present study was to identify risk factors for physical frailty and to understand the transitional status of frailty. Methods: The participants were 4676 older adults in the National Center for Geriatrics and Gerontology ‐ Study of Geriatric Syndromes. Physical frailty status was classified as robust, pre‐frail and frail at baseline and 4‐year follow up (mean follow up 47.9 ± 1.8 months). Data for demographic variables, medical conditions, fall, depressive symptoms and cognitive function were also collected. Multiple imputation was used to reduce selection bias and loss of information. Results: Progression occurred from a robust to frail status in 52 participants (2.6%) and from pre‐frailty to frailty in 281 participants (12.0%). Mortality increased with frailty status at baseline: robust 46 (2.3%), pre‐frail 112 (4.8%) and frail 54 (15.6%). In logistic regression analysis, age (OR 1.10, 95% CI 1.06–1.13), sex (men; OR 0.67, 95% CI 0.46–0.95), body mass index (OR 1.06, 95% CI 1.01–1.12]), fall (OR 1.92, 95% CI 1.31–2.81), Geriatric Depression Scale (OR 1.15, 95% CI 1.08–1.22), Mini‐Mental State Examination (OR 0.87, 95% CI 0.82–0.93) and education (OR 0.91, 95% CI 0.85–0.98), were related with new incident frailty. Among participants in the pre‐frail class at baseline, exhaustion (OR 3.24, 95% CI 1.97–5.34), physical inactivity (OR 3.09, 95% CI 1.94–4.93), lower muscle strength (OR 3.77, 95% CI 2.35–6.03) and lower mobility (OR 2.54, 95% CI 1.57–4.10) were related to progression to frailty (all P < 0.05). Conclusions: The results of the present prospective study provide key information on the transitional status of frailty and the risk factors for progression to frailty. A further study is required to determine the pathophysiological changes that underlie the transition to frailty. Geriatr Gerontol Int 2018; 18: 1562–1566. [ABSTRACT FROM AUTHOR]