Can We Distinguish Age-Related Frailty from Frailty Related to Diseases? Data from the MAPT Study
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CAN WE DISTINGUISH AGE-RELATED FRAILTY FROM FRAILTY RELATED TO DISEASES ? DATA FROM THE MAPT STUDY D. ANGIONI1,2, T. MACARON1,2, C. TAKEDA1, S. SOURDET1, M. CESARI3, K. VIRECOULON GIUDICI2, J. RAFFIN2, W.H. LU2, J. DELRIEU1, J. TOUCHON4, Y. ROLLAND1,2,5, P. DE SOUTO BARRETO2,5, B. VELLAS1,2,5 AND THE MAPT/DSA GROUP* 1. Gerontopole of Toulouse, La Grave Hospital, Toulouse University Hospital (CHU Toulouse), Toulouse, France; 2. Gerontopole of Toulouse, Ageing Institut, Toulouse University Hospital (CHU Toulouse), Toulouse, France; 3. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; 4. Department of Neurology, University Hospital of Montpellier, Montpellier, France; 5. UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France. * Members are listed in the end of the manuscript. Corresponding author: Davide Angioni, Gerontopole of Toulouse, 37 A Jules Guesde, 31000 Toulouse, [email protected]
Abstract: Background: No study has tried to distinguish subjects that become frail due to diseases (frailty related to diseases) or in the absence of specific medical events; in this latter case, it is possible that aging process would act as the main frailty driver (age-related frailty). Objectives: To classify subjects according to the origin of physical frailty: age-related frailty, frailty related to diseases, frailty of uncertain origin, and to compare their clinical characteristics. Materials and methods: We performed a secondary analysis of the Multidomain Alzheimer Preventive Trial (MAPT), including 195 subjects ≥70 years non-frail at baseline who became frail during a 5-year follow-up (mean age 77.8 years ± 4.7; 70% female). Physical frailty was defined as presenting ≥3 of the 5 Fried criteria: weight loss, exhaustion, weakness, slowness, low physical activity. Clinical files were independently reviewed by two different clinicians using a standardized assessment method in order to classify subjects as: “age-related frailty”, “frailty related to diseases” or “frailty of uncertain origin”. Inconsistencies among the two raters and cases of uncertain frailty were further assessed by two other experienced clinicians. Results: From the 195 included subjects, 82 (42%) were classified as age-related frailty, 53 (27%) as frailty related to diseases, and 60 (31%) as frailty of uncertain origin. Patients who became frail due to diseases did not differ from the others groups in terms of functional, cognitive, psychological status and age at baseline, however they presented a higher burden of comorbidity as measured by the Cumulative Illness Rating Scale (CIRS) (8.20 ± 2.69; vs 6.22 ± 2.02 frailty of uncertain origin; vs. 3.25 ± 1.65 age-related frailty). Time to incident frailty (23.4 months ± 12.1 vs. 39.2 ± 19.3 months) and time spent in a pre-frailty condition (17.1 ± 11.4 vs 26.6 ± 16.6 months) were shorter in the group of frailty related to diseases compared to age-related frailty. Orthopedic diseases (n=14, 26%) were the most common pathologies leading to frailty related to
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