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Comparison of the Simplified sWHI and the Standard CHS Frailty Phenotypes for Prediction of Mortality, Incident Falls, and Hip Fractures in Older Women.
Zaslavsky, O, Zelber-Sagi, S, LaCroix, AZ, Brunner, RL, Wallace, RB, Cochrane, BB, Woods, NF
The journals of gerontology. Series A, Biological sciences and medical sciences. 2017;(10):1394-1400
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Abstract
BACKGROUND We compared the simplified Women's Health Initiative (sWHI) and the standard Cardiovascular Health Study (CHS) frailty phenotypes in predicting falls, hip fracture, and death in older women. METHODS Participants are from the WHI Clinical Trial. CHS frailty criteria included weight loss, exhaustion, weakness, slowness, and low physical activity. The sWHI frailty score used two items from the RAND-36 physical function and vitality subscales, one item from the WHI physical activity scale plus the CHS weight loss criteria. Specifically, level of physical function was the capacity to walk one block and scored as severe (2-points), moderate (1-point), or no limitation (0). Vitality was based on feeling tired most or all of the time (1-point) versus less often (0). Low physical activity was walking outside less than twice a week (1-point) versus more often (0). A total score of 3 resulted in a frailty classification, a score of 1 or 2 defined pre-frailty, and 0 indicated nonfrailty. Outcomes were modeled using Cox regression and Harrell C-statistics were used for comparisons. RESULTS Approximately 5% of the participants were frail based on the CHS or sWHI phenotype. The sWHI frailty phenotype was associated with higher rates of mortality (hazard ratio [HR] = 2.36, p ≤ .001) and falls (HR = 1.45, p = .005). Comparable HRs in CHS-phenotype were 1.97 (p < .001) and 1.36 (p = .03), respectively. Neither phenotype predicted hip fracture. Harrell C-statistics revealed nonsignificant differences in HRs between the CHS and sWHI frailty phenotypes. CONCLUSION The sWHI phenotype, which is self-reported and brief, might be practical in settings with limited resources.
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Comparison of frailty among Japanese, Brazilian Japanese descendants and Brazilian community-dwelling older women.
Sampaio, PY, Sampaio, RA, Yamada, M, Ogita, M, Arai, H
Geriatrics & gerontology international. 2015;(6):762-9
Abstract
AIM: To investigate frailty in Japanese, Brazilian Japanese descendants and Brazilian older women. METHODS The collected data included sociodemographic and health-related characteristics, and the frailty index Kihon Checklist. We analyzed the differences between the mean scores of Kihon Checklist domains (using ancova) and the percentage of frail women (using χ(2)-test). We carried out a binary logistic regression with Kihon Checklist domains. RESULTS A total of 211 participants (Japanese n = 84, Brazilian Japanese descendants n = 55, Brazilian n = 72) participated in this research. The Brazilian participants had the highest total Kihon Checklist scores (more frail), whereas the Brazilian Japanese descendants had the lowest scores (P < 0.001). Furthermore, the Brazilian group had more participants with oral dysfunction (P < 0.001), seclusion (P < 0.001), cognitive impairment (P < 0.001) and depression (P < 0.001). They were more likely to be frail (OR 5.97, 95% CI 2.69-13.3, P < 0.001), to have oral dysfunction (OR 3.18, 95% CI 1.47-6.85, P = 0.003), seclusion (OR 9.15, 95% CI 3.53-23.7, P < 0.001), cognitive impairment (OR 3.87, 95% CI 1.93-7.75, P < 0.001) and depression (OR 6.63, 95% CI 2.74-16.0, P < 0.001) than the Japanese group. CONCLUSIONS The older Brazilian women were likely to be more frail than the participants in other groups. More than the environment itself, the lifestyle and sociodemographic conditions could affect the frailty of older Brazilian women.