Prognostic impact of main frailty domain trajectories on 5-year mortality in very old adults: results from the PARTAGE cohort study

Prognostic impact of main frailty domain trajectories on 5-year mortality in very old adults:... Abstract The objectives were to identify trajectories of nutrition, cognitive function and autonomy over time in very old adults and to assess their impact on mortality. A cohort, including subjects aged≥80 years in 2007-2008, who were followed for 5 years, in 72 Italian and French nursing homes, was used for post-hoc analyses. Body mass index (BMI), Mini Mental State Examination (MMSE), and index of activities of daily living (ADL) were assessed at 4 time points. Vital status was collected during the follow-up. Latent trajectory and Cox models were used. In the 710 subjects included, the mean(SD) age at inclusion was 88.0(0.8) years, and 78.9% were female. Seven composite trajectories were identified based on BMI, MMSE, and ADL values. As compared to the reference group (T7—stable overweight, preserved cognitive function and autonomy), two trajectories presented increased relative risk of dying: T1, stable overweight, moderately impaired then declining cognitive function and autonomy (adjusted HR = 1.79, 95%CI: 1.26,2.55), and T6, stable normal BMI, slight cognitive decline, and moderate then degrading loss of autonomy (adjusted HR = 1.67, 95%CI: 1.15,2.44). C-index was 0.81, 95%CI: 0.72,0.88. A repeated monitoring of BMI, MMSE, and ADL in very old adults provides trajectories with higher prognostic information than simple baseline assessment. [MeSH]: Holistic Health, Nutritional status, Cognitive aging, Frail Elderly, Age, 80 and over, Prognosis © The Author(s) 2018. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Epidemiology Oxford University Press

Prognostic impact of main frailty domain trajectories on 5-year mortality in very old adults: results from the PARTAGE cohort study

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Publisher
Oxford University Press
Copyright
© The Author(s) 2018. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
ISSN
0002-9262
eISSN
1476-6256
D.O.I.
10.1093/aje/kwy050
Publisher site
See Article on Publisher Site

Abstract

Abstract The objectives were to identify trajectories of nutrition, cognitive function and autonomy over time in very old adults and to assess their impact on mortality. A cohort, including subjects aged≥80 years in 2007-2008, who were followed for 5 years, in 72 Italian and French nursing homes, was used for post-hoc analyses. Body mass index (BMI), Mini Mental State Examination (MMSE), and index of activities of daily living (ADL) were assessed at 4 time points. Vital status was collected during the follow-up. Latent trajectory and Cox models were used. In the 710 subjects included, the mean(SD) age at inclusion was 88.0(0.8) years, and 78.9% were female. Seven composite trajectories were identified based on BMI, MMSE, and ADL values. As compared to the reference group (T7—stable overweight, preserved cognitive function and autonomy), two trajectories presented increased relative risk of dying: T1, stable overweight, moderately impaired then declining cognitive function and autonomy (adjusted HR = 1.79, 95%CI: 1.26,2.55), and T6, stable normal BMI, slight cognitive decline, and moderate then degrading loss of autonomy (adjusted HR = 1.67, 95%CI: 1.15,2.44). C-index was 0.81, 95%CI: 0.72,0.88. A repeated monitoring of BMI, MMSE, and ADL in very old adults provides trajectories with higher prognostic information than simple baseline assessment. [MeSH]: Holistic Health, Nutritional status, Cognitive aging, Frail Elderly, Age, 80 and over, Prognosis © The Author(s) 2018. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices)

Journal

American Journal of EpidemiologyOxford University Press

Published: Mar 15, 2018

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