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Transitions between frailty states in the very old: the influence of socioeconomic status and multi-morbidity in the Newcastle 85+ cohort study

Lookup NU author(s): Dr Nuno Mendonca, Dr Andrew KingstonORCiD, Helen Hanson, Dr Rachel Duncan, Emerita Professor Carol Jagger, Dr Louise Robinson



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society.BACKGROUND: Using Newcastle 85+ Study data, we investigated transitions between frailty states from age 85 to 90 years and whether multi-morbidities and socioeconomic status (SES) modify transitions. METHODS: The Newcastle 85+ Study is a prospective, longitudinal cohort study of all people born in 1921 in Newcastle and North Tyneside. Data included: a multidimensional health assessment; general practice record review (GPRR) and date of death. Using the Fried phenotype (participants defined as robust, pre-frail or frail), frailty was measured at baseline, 18, 36 and 60 months. RESULTS: Frailty scores were available for 82% (696/845) of participants at baseline. The prevalence of frailty was higher in women (29.7%, 123/414) than men (17.7%, 50/282) at baseline and all subsequent time points. Of those robust at baseline, 44.6% (50/112) remained robust at 18 months and 28% (14/50) at age 90. Most (52%) remained in the same state across consecutive interviews; only 6% of the transitions were recovery (from pre-frail to robust or frail to pre-frail), and none were from frail to robust. Four or more diseases inferred a greater likelihood of progression from robust to pre-frail even after adjustment for SES. SES did not influence the likelihood of moving from one frailty state to another. CONCLUSIONS: Almost half the time between age 85 and 90, on average, was spent in a pre-frail state; multi-morbidity increased the chance of progression from robust and to frail; greater clinical intervention at the onset of a first chronic illness, to prevent transition to multi-morbidity, should be encouraged.

Publication metadata

Author(s): Mendonca N, Kingston A, Yadegarfar M, Hanson H, Duncan R, Jagger C, Robinson L

Publication type: Article

Publication status: Published

Journal: Age and Ageing

Year: 2020

Volume: 49

Issue: 6

Pages: 974-981

Online publication date: 28/04/2020

Acceptance date: 02/04/2016

Date deposited: 09/11/2020

ISSN (print): 0002-0729

ISSN (electronic): 1468-2834

Publisher: Oxford University Press


DOI: 10.1093/ageing/afaa054

PubMed id: 32342980


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Funder referenceFunder name
British Heart Foundation (PG/08/026/24712)
Biotechnology and Biological Sciences Research Council
Medical Research Council (G0500997, G0601333, MR/J50001X/1)
National Health Service or the Department of Health.