HomeLarge Type Edition
HOME ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Services
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
PubMed
Right arrow PubMed Citation
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 61:262-266 (2006)
© 2006 The Gerontological Society of America

Phenotype of Frailty: Characterization in the Women's Health and Aging Studies

Karen Bandeen-Roche, Qian-Li Xue, Luigi Ferrucci, Jeremy Walston, Jack M. Guralnik, Paulo Chaves, Scott L. Zeger and Linda P. Fried

1 Department of Biostatistics, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
2 Center on Aging and Health and 3 Division of Geriatric Medicine and Gerontology, Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland.
4 Clinical Research Branch, Intramural Research Program, National Institute on Aging, Baltimore, Maryland.
5 Division of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, Maryland.

Address correspondence to Karen Bandeen-Roche, PhD, Department of Biostatistics, The Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205. E-mail: kbandeen{at}jhsph.edu

Background. "Frailty" is an adverse, primarily gerontologic, health condition regarded as frequent with aging and having severe consequences. Although clinicians claim that the extremes of frailty can be easily recognized, a standardized definition of frailty has proved elusive until recently. This article evaluates the cross-validity, criterion validity, and internal validity in the Women's Health and Aging Studies (WHAS) of a discrete measure of frailty recently validated in the Cardiovascular Health Study (CHS).

Methods. The frailty measure developed in CHS was delineated in the WHAS data sets. Using latent class analysis, we evaluated whether criteria composing the measure aggregate into a syndrome. We verified the criterion validity of the measure by testing whether participants defined as frail were more likely than others to develop adverse geriatric outcomes or to die.

Results. The distributions of frailty in the WHAS and CHS were comparable. In latent class analyses, the measures demonstrated strong internal validity vis à vis stated theory characterizing frailty as a medical syndrome. In proportional hazards models, frail women had a higher risk of developing activities of daily living (ADL) and/or instrumental ADL disability, institutionalization, and death, independently of multiple potentially confounding factors.

Conclusions. The findings of this study are consistent with the widely held theory that conceptualizes frailty as a syndrome. The frailty definition developed in the CHS is applicable across diverse population samples and identifies a profile of high risk of multiple adverse outcomes.




This article has been cited by other articles:


Home page
 J Gerontol A Biol Sci Med SciHome page
M. Shardell, G. E. Hicks, R. R. Miller, S. Kritchevsky, D. Andersen, S. Bandinelli, A. Cherubini, and L. Ferrucci
Association of Low Vitamin D Levels With the Frailty Syndrome in Men and Women
J Gerontol A Biol Sci Med Sci, January 20, 2009; (2009) gln007v1.
[Abstract] [Full Text] [PDF]

Home page
 Age AgeingHome page
R. E. Hubbard, M. S. O'Mahony, and K. W. Woodhouse
Characterising frailty in the clinical setting--a comparison of different approaches
Age Ageing, January 1, 2009; 38(1): 115 - 119.
[Full Text] [PDF]

Home page
 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
B. E. Alvarado, M.-V. Zunzunegui, F. Beland, and J.-M. Bamvita
Life Course Social and Health Conditions Linked to Frailty in Latin American Older Men and Women
J. Gerontol. A Biol. Sci. Med. Sci., December 1, 2008; 63(12): 1399 - 1406.
[Abstract] [Full Text] [PDF]

Home page
 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
J. A. Avila-Funes, C. Helmer, H. Amieva, P. Barberger-Gateau, M. L. Goff, K. Ritchie, F. Portet, I. Carriere, B. Tavernier, L. M. Gutierrez-Robledo, et al.
Frailty Among Community-Dwelling Elderly People in France: The Three-City Study
J. Gerontol. A Biol. Sci. Med. Sci., October 1, 2008; 63(10): 1089 - 1096.
[Abstract] [Full Text] [PDF]

Home page
 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
Q.-L. Xue, K. Bandeen-Roche, R. Varadhan, J. Zhou, and L. P. Fried
Initial Manifestations of Frailty Criteria and the Development of Frailty Phenotype in the Women's Health and Aging Study II
J. Gerontol. A Biol. Sci. Med. Sci., September 1, 2008; 63(9): 984 - 990.
[Abstract] [Full Text] [PDF]

Home page
 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
A. R. Cappola, M. Maggio, and L. Ferrucci
Is Research on Hormones and Aging Finished? No! Just Started!
J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2008; 63(7): 696 - 698.
[Full Text] [PDF]

Home page
 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
H. Cheng, B. J. Gurland, and M. S. Maurer
Self-Reported Lack of Energy (Anergia) Among Elders in a Multiethnic Community
J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2008; 63(7): 707 - 714.
[Abstract] [Full Text] [PDF]

Home page
 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
F. Retornaz, J. Monette, G. Batist, M. Monette, N. Sourial, D. Small, S. Caplan, D. Wan-Chow-Wah, M. T. E. Puts, and H. Bergman
Usefulness of Frailty Markers in the Assessment of the Health and Functional Status of Older Cancer Patients Referred for Chemotherapy: A Pilot Study
J. Gerontol. A Biol. Sci. Med. Sci., May 1, 2008; 63(5): 518 - 522.
[Abstract] [Full Text] [PDF]

Home page
 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
M. E. Cress, G. Mueller, and S. Orini
RESPONSE TO SPECIAL MEDICAL SCIENCES SECTION ON UNCONVENTIONAL VIEWS OF FRAILTY
J. Gerontol. A Biol. Sci. Med. Sci., May 1, 2008; 63(5): 542 - 542.
[Full Text] [PDF]

Home page
 Research on AgingHome page
E. Guilley, P. Ghisletta, F. Armi, A. Berchtold, C. L. d'Epinay, J.-P. Michel, and A. de Ribaupierre
Dynamics of Frailty and ADL Dependence in a Five-Year Longitudinal Study of Octogenarians
Research on Aging, May 1, 2008; 30(3): 299 - 317.
[Abstract] [PDF]

Home page
 Arch Intern MedHome page
K. E. Ensrud, S. K. Ewing, B. C. Taylor, H. A. Fink, P. M. Cawthon, K. L. Stone, T. A. Hillier, J. A. Cauley, M. C. Hochberg, N. Rodondi, et al.
Comparison of 2 Frailty Indexes for Prediction of Falls, Disability, Fractures, and Death in Older Women
Arch Intern Med, February 25, 2008; 168(4): 382 - 389.
[Abstract] [Full Text] [PDF]

Home page
 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
L. Ferrucci
Throwing Pots and Commitments for 2008
J. Gerontol. A Biol. Sci. Med. Sci., February 1, 2008; 63(2): 157 - 159.
[Full Text] [PDF]

Home page
 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
R. Varadhan, J. Walston, A. R. Cappola, M. C. Carlson, G. S. Wand, and L. P. Fried
Higher Levels and Blunted Diurnal Variation of Cortisol in Frail Older Women
J. Gerontol. A Biol. Sci. Med. Sci., February 1, 2008; 63(2): 190 - 195.
[Abstract] [Full Text] [PDF]

Home page
 Am J EpidemiolHome page
Q.-L. Xue, L. P. Fried, T. A. Glass, A. Laffan, and P. H. M. Chaves
Life-Space Constriction, Development of Frailty, and the Competing Risk of Mortality: The Women's Health and Aging Study I
Am. J. Epidemiol., January 15, 2008; 167(2): 240 - 248.
[Abstract] [Full Text] [PDF]

Home page
 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
M. A. Espeland, T. M. Gill, J. Guralnik, M. E. Miller, R. Fielding, A. B. Newman, M. Pahor, and for the Lifestyle Interventions and Independence f
Designing Clinical Trials of Interventions for Mobility Disability: Results From the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) Trial
J. Gerontol. A Biol. Sci. Med. Sci., November 1, 2007; 62(11): 1237 - 1243.
[Abstract] [Full Text] [PDF]

Home page
 J. Am. Soc. Nephrol.Home page
K. L. Johansen, G. M. Chertow, C. Jin, and N. G. Kutner
Significance of Frailty among Dialysis Patients
J. Am. Soc. Nephrol., November 1, 2007; 18(11): 2960 - 2967.
[Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
W. B. Ershler
A gripping reality: oxidative stress, inflammation, and the pathway to frailty
J Appl Physiol, July 1, 2007; 103(1): 3 - 5.
[Full Text] [PDF]

Home page
 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
K. Rockwood and A. Mitnitski
Frailty in Relation to the Accumulation of Deficits
J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2007; 62(7): 722 - 727.
[Abstract] [Full Text] [PDF]

Home page
 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
H. E. Whitson, J. L. Purser, and H. J. Cohen
Frailty Thy Name Is ... Phrailty?
J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2007; 62(7): 728 - 730.
[Full Text] [PDF]

Home page
 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
H. Bergman, L. Ferrucci, J. Guralnik, D. B. Hogan, S. Hummel, S. Karunananthan, and C. Wolfson
Frailty: An Emerging Research and Clinical Paradigm Issues and Controversies
J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2007; 62(7): 731 - 737.
[Abstract] [Full Text] [PDF]

Home page
 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
K. Rockwood, M. Andrew, and A. Mitnitski
A Comparison of Two Approaches to Measuring Frailty in Elderly People
J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2007; 62(7): 738 - 743.
[Abstract] [Full Text] [PDF]

Home page
 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
K. E. Ensrud, S. K. Ewing, B. C. Taylor, H. A. Fink, K. L. Stone, J. A. Cauley, J. K. Tracy, M. C. Hochberg, N. Rodondi, P. M. Cawthon, et al.
Frailty and Risk of Falls, Fracture, and Mortality in Older Women: The Study of Osteoporotic Fractures
J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2007; 62(7): 744 - 751.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
H. K. Sanoff, H. Bleiberg, and R. M. Goldberg
Managing Older Patients With Colorectal Cancer
J. Clin. Oncol., May 10, 2007; 25(14): 1891 - 1897.
[Abstract] [Full Text] [PDF]

Home page
 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
L. Ferrucci
A Year of Excellence in Geriatric Research and Some New Dishes on the Menu
J. Gerontol. A Biol. Sci. Med. Sci., May 1, 2007; 62(5): 516 - 518.
[Full Text] [PDF]

Home page
 Arch Intern MedHome page
J. I. Barzilay, C. Blaum, T. Moore, Q. Li Xue, C. H. Hirsch, J. D. Walston, and L. P. Fried
Insulin Resistance and Inflammation as Precursors of Frailty: The Cardiovascular Health Study
Arch Intern Med, April 9, 2007; 167(7): 635 - 641.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
K. S. Boockvar and D. E. Meier
Palliative care for frail older adults: "there are things I can't do anymore that I wish I could . . . ".
JAMA, November 8, 2006; 296(18): 2245 - 2253.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
H. Fillit
"Our Parents, Ourselves"--Reply
JAMA, November 1, 2006; 296(17): 2093 - 2093.
[Full Text] [PDF]


HOME ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2006 by The Gerontological Society of America.