Prognostic Association of Major Frailty Domain Trajectories With 5-Year Mortality in Very Old Adults: Results From the PARTAGE Cohort Study. Issue 8 (15th March 2018)

• Record Type: Journal Article
• Authors: Agrinier, Nelly; Erpelding, Marie-Line; Labat, Carlos; Gautier, Sylvie; Guillemin, Francis; Benetos, Athanase
• Is Part Of: American journal of epidemiology. Volume 187:Issue 8(2018)
• Page Start: 1678
• Page End: 1685
• Publication Date: 2018-03-15
• Subjects: aged, 80 and over -- cognitive aging -- frail elderly -- holistic health -- nutritional status -- prognosis; Epidemiology -- Periodicals; Public health -- Periodicals; 614.4
• DOI: 10.1093/aje/kwy050
• Languages: English
• ISSNs: 0002-9262

Abstract

Abstract: We aimed to identify trajectories of nutrition, cognitive function, and autonomy over time among very old adults and to assess their impact on mortality. A cohort of 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; weight (kg)/height (m) 2 ), Mini-Mental State Examination (MMSE) score, and Katz Index of Independence in Activities of Daily Living (ADL) score were assessed at 4 time points. Information on vital status was collected during follow-up. Latent trajectory and Cox models were used. In the 710 subjects included, the mean age at inclusion was 88.0 (standard deviation, 4.8) years, and 78.9% were female. We identified 7 composite trajectories based on BMI, MMSE, and ADL values. As compared with the reference group (trajectory 7—stable overweight; preserved cognitive function and autonomy), 2 trajectories presented increased hazards of dying: trajectory 1 (stable overweight; moderately impaired, then declining, cognitive function and autonomy (adjusted hazard ratio = 1.79, 95% confidence interval (CI): 1.26, 2.55)) and trajectory 6 (stable normal BMI; slight cognitive decline; and moderate, then degrading, loss of autonomy (adjusted hazard ratio = 1.67, 95% CI: 1.15, 2.44)). The C-index was 0.81 (95% CI: 0.72, 0.88). Repeated monitoring of BMI, MMSE score, and ADL in very old adults provides trajectories that produce better prognostic information than simple baseline assessment.