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J Am Geriatr Soc. 2014 May;62(5):821-8. doi: 10.1111/jgs.12792. Epub 2014 Apr 18.

Effect of health protective factors on health deficit accumulation and mortality risk in older adults in the Beijing Longitudinal Study of Aging.

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  • 1Department of Evidence-based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.

Abstract

OBJECTIVES:

To evaluate transitions in health status and risk of death in older adults in relation to baseline health deficits and protective factors.

DESIGN:

Prospective cohort study with reassessments at 5, 8, and 15 years.

SETTING:

Secondary analysis of data from the Beijing Longitudinal Study on Aging.

PARTICIPANTS:

Urban and rural community-dwelling people aged 55 and older at baseline (n = 3,275), followed from 1992 to 2007, during which time 51% died.

MEASUREMENTS:

Health status was quantified using the deficit accumulation-based frailty index (FI), constructed from 30 intrinsic health measures. A protection index was constructed using 14 extrinsic items (e.g., exercise, education). The probabilities of health changes, including death, were evaluated using a multistate transition model.

RESULTS:

Women had more health deficits (mean baseline FI 0.13 ± 0.11) than did men (mean baseline FI 0.11 ± 0.10). Although health declined on average (mean FIs increased), improvement and stability were common. Baseline health significantly affected health transitions and survival over various follow-up durations (odds ratio (OR) = 1.27, 95% confidence interval (CI) = 1.17-1.37 for men; OR = 1.24, 95% CI = 1.16-1.33 for women for each increment of deficits). Each protective factor reduced the risk of health decline and the risk of death in men and women by 13% to 25%.

CONCLUSION:

Deficit accumulation-based transition modeling demonstrates persisting effects of baseline health status on age-related health outcomes. Some mitigation by protective factors can be demonstrated, suggesting that improving physical and social conditions might be beneficial.

© 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

KEYWORDS:

aging; frailty; frailty index; health transitions; protection index

PMID:
24749784
[PubMed - indexed for MEDLINE]
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