Comparing models of frailty: the Health and Retirement Study.

TitleComparing models of frailty: the Health and Retirement Study.
Publication TypeJournal Article
Year of Publication2009
AuthorsCigolle, CT, Ofstedal, MBeth, Tian, Z, Blaum, CS
JournalJ Am Geriatr Soc
Date Published2009 May
ISSN Number1532-5415
Call Numbernewpubs20090908_Cigolle_etal.pdf
KeywordsActivities of Daily Living, Aged, Aged, 80 and over, Chronic disease, Cross-Sectional Studies, Demography, Disability Evaluation, Frail Elderly, Geriatric Assessment, Health Surveys, Humans, Interviews as Topic, Logistic Models, Models, Theoretical, United States

OBJECTIVES: To operationalize and compare three models of frailty, each representing a distinct theoretical view of frailty: as deficiencies in function (Functional Domains model), as an index of health burden (Burden model), and as a biological syndrome (Biologic Syndrome model).

DESIGN: Cross-sectional analysis.

SETTING: 2004 wave of the Health and Retirement Study, a nationally representative, longitudinal health interview survey.

PARTICIPANTS: Adults aged 65 and older (N=11,113) living in the community and in nursing homes in the United States.

MEASUREMENTS: The outcome measure was the presence of frailty, as defined according to each frailty model. Covariates included chronic diseases and sociodemographic characteristics.

RESULTS: Almost one-third (30.2%) of respondents were frail according to at least one model; 3.1% were frail according to all three models. The Functional Domains model showed the least overlap with the other models. In contrast, 76.1% of those classified as frail according to the Biologic Syndrome model and 72.1% of those according to the Burden model were also frail according to at least one other model. Older adults identified as frail according to the different models differed in sociodemographic and chronic disease characteristics. For example, the Biologic Syndrome model demonstrated substantial associations with older age (adjusted odds ratio (OR)=10.6, 95% confidence interval (CI)=6.1-18.5), female sex (OR=1.7, 95% CI=1.2-2.5), and African-American ethnicity (OR=2.1, % CI=1.0-4.4).

CONCLUSION: Different models of frailty, based on different theoretical constructs, capture different groups of older adults. The different models may represent different frailty pathways or trajectories to adverse outcomes such as disability and death.

User Guide Notes

Endnote Keywords

FRAILTY/Models, Theoretical

Endnote ID


Alternate JournalJ Am Geriatr Soc
Citation Key7338
PubMed ID19453306
Grant ListF32 AG027649 / AG / NIA NIH HHS / United States
R01 AG021493A / AG / NIA NIH HHS / United States
1F32AG027649-01 / AG / NIA NIH HHS / United States