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Adverse outcomes of frailty in the elderly: the Rotterdam Study

  • GERIATRIC EPIDEMIOLOGY
  • Published:
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Abstract

To investigate the prevalence of frailty in a Dutch elderly population and to identify adverse health outcomes associated with the frailty phenotype independent of the comorbidities. Cross-sectional and longitudinal analyses within the Rotterdam Study (the Netherlands), a prospective population-based cohort study in persons aged ≥55 years. Frailty was defined as meeting three or more of five established criteria for frailty, evaluating nutritional status, physical activity, mobility, grip strength and exhaustion. Intermediate frailty was defined as meeting one or two frailty criteria. Comorbidities were objectively measured. Health outcomes were assessed by means of questionnaires, physical examinations and continuous follow-up through general practitioners and municipal health authorities for mortality. Of 2,833 participants (median age 74.0 years, inter quartile range 9) with sufficiently evaluated frailty criteria, 163 (5.8 %) participants were frail and 1,454 (51.3 %) intermediate frail. Frail elderly were more likely to be older and female, to have an impaired quality of life and to have fallen or to have been hospitalized. 108 (72.0 %) frail participants had ≥2 comorbidities, compared to 777 (54.4 %) intermediate frail and 522 (44.8 %) non-frail participants. Adjusted for age, sex and comorbidities, frail elderly had a significantly increased risk of dying within 3 years (HR 3.4; 95 % CI 1.9–6.4), compared to the non-frail elderly. This study in a general Dutch population of community-dwelling elderly able to perform the frailty tests, demonstrates that frailty is common and that frail elderly are at increased risk of death independent of comorbidities.

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Abbreviations

BMI:

Body mass index

CES-D:

Center for epidemiological studies depression

CI:

Confidence interval

COPD:

Chronic obstructive pulmonary disease

FEV1 :

Forced expiratory volume in 1 s

FVC:

Forced vital capacity

Hb:

Hemoglobin

HR:

Hazard ratio

IQR:

Inter quartile range

OR:

Odds ratio

QoL:

Quality of life

RS:

Rotterdam Study

WBC:

White blood cells

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Acknowledgments

The authors thank the study participants, the staff from the Rotterdam Study, J. Verkroost, F. van Rooij, M. Leening, R. Ruiter and the participating general practitioners. This study was supported by the Fund for Scientific Research Flanders (FWO) project G035014 N. The funding source had no involvement in the collection, analysis, writing, interpretation, nor in the decision to submit the paper for publication. Researchers were independent from funders for this work.

Conflict of interest

None of the authors has important conflicts of interest with relevance to the submitted work.

Author information

Authors and Affiliations

  1. Department of Respiratory Medicine, Ghent University Hospital, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium

    Lies Lahousse, Bastiaan Maes & Guy G. Brusselle

  2. Departments of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands

    Lies Lahousse, Bastiaan Maes, Gijsbertus Ziere, Daan W. Loth, Vincentius J. A. Verlinden, André G. Uitterlinden, Fernando Rivadeneira, Henning Tiemeier, Oscar H. Franco, M. Arfan Ikram, Albert Hofman, Guy G. Brusselle & Bruno H. Stricker

  3. Departments of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands

    Vincentius J. A. Verlinden & M. Arfan Ikram

  4. Departments of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands

    M. Carola Zillikens, André G. Uitterlinden & Fernando Rivadeneira

  5. Departments of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands

    M. Arfan Ikram

  6. Departments of Respiratory Medicine, Erasmus Medical Center, Rotterdam, The Netherlands

    Guy G. Brusselle

  7. Netherlands Consortium on Healthy Aging (NCHA), Leiden, The Netherlands

    M. Carola Zillikens, André G. Uitterlinden, Fernando Rivadeneira, Henning Tiemeier, Oscar H. Franco, M. Arfan Ikram, Albert Hofman & Bruno H. Stricker

  8. Inspectorate of Healthcare, The Hague, The Netherlands

    Bruno H. Stricker

Authors
  1. Lies Lahousse
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  2. Bastiaan Maes
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  3. Gijsbertus Ziere
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  10. Oscar H. Franco
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  12. Albert Hofman
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  13. Guy G. Brusselle
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  14. Bruno H. Stricker
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Corresponding author

Correspondence to Bruno H. Stricker.

Additional information

Lies Lahousse and Bastiaan Maes have contributed equally to this work.

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Lahousse, L., Maes, B., Ziere, G. et al. Adverse outcomes of frailty in the elderly: the Rotterdam Study. Eur J Epidemiol 29, 419–427 (2014). https://doi.org/10.1007/s10654-014-9924-1

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  • DOI: https://doi.org/10.1007/s10654-014-9924-1

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