Prefrailty subtypes differentially predict 5-year mortality in the functionally independent geriatric population.

Area of Science:

• Gerontology
• Geriatric Medicine
• Public Health

Background:

• Frailty and prefrailty (PF) are established risk factors for mortality in older populations.
• Existing research lacks consensus on prefrailty subtypes for predicting mortality risk.
• Geriatric outpatients represent a vulnerable population where understanding frailty trajectories is crucial.

Purpose of the Study:

• To compare the 5-year mortality risk across different prefrailty subtypes and frailty in functionally independent geriatric outpatients.
• To identify specific prefrailty criteria that are most predictive of mortality.
• To inform clinical practice regarding risk stratification and intervention for prefrail and frail older adults.

Main Methods:

• A single-center, retrospective cohort study involving 982 community-dwelling older adults from a geriatric outpatient clinic in Taiwan.
• Pre-frailty was categorized into PF1 (exhaustion and/or weight loss) and PF2 (weakness, slowness, and/or low physical activity). Frailty was defined by three or more criteria.
• Kaplan-Meier survival analysis was employed to assess 5-year survival rates among nonfrail, PF1, PF2, and frail groups, with Cox proportional hazards models used for risk assessment.

Main Results:

• Prevalence of prefrailty (45.7%) and frailty (24.5%) was substantial in this functionally independent outpatient cohort.
• Cumulative 5-year survival rates were 98.6% for nonfrail, 95.8% for PF1, 89.1% for PF2, and 81.3% for frail individuals.
• Significant predictors of 5-year mortality included older age, male sex, the PF2 subtype, and frailty, with hazard ratios indicating substantially increased risk for PF2 and frailty.

Conclusions:

• Pre-frailty, particularly the PF2 subtype, and frailty are significant determinants of 5-year mortality in functionally independent geriatric outpatients.
• Early identification of individuals with the PF2 subtype and implementation of timely interventions may improve survival outcomes.
• These findings underscore the importance of detailed phenotyping of prefrailty for accurate risk assessment in geriatric care.