Frailty trajectories and mortality risk in community-dwelling older adults: a 9-year follow-up study

Frailty is a well-established risk factor for adverse health outcomes, yet its dynamic nature and predictors remain partially understood. This study aimed to investigate factors influencing frailty transitions and mortality risk among community-dwelling older adults.

We conducted a longitudinal study using a 9-year follow-up data from the Health, Well-being, and Aging Study (SABE, as known in Portuguese). A Markov model, fitted via multinomial logistic regression, identified factors independently associated with frailty transitions between waves. Four trajectory groups were identified: stable, worsening, improving, and fluctuating.

A total of 1399 individuals aged 60 and older (61.8% female) were enrolled, with a mean age of 73.9 (SD ± 9.2) years. Among frailty transitions, 37.8% remained stable, 56.4% worsened, 1.3% improved, and 4.4% fluctuated. After adjusting for baseline variables, we found that older age, cognitive impairment, multimorbidity, and depressive symptoms were significantly linked to a higher risk of being frail at the next visit. The mortality risk was associated with male sex, older age, frailty, cognitive impairment, and multimorbidity.

Sociodemographic and health-related factors contribute to increased risk of experiencing frailty and mortality among community-dwelling older adults. Further research is needed to identify modifiable factors influencing frailty transitions.