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SHR Neuro Cancer Cardio Lipid Metab Microb
Stolz, E; Mayerl, H; Hoogendijk, EO; Armstrong, JJ; Roller-Wirnsberger, R; Freidl, W.
Acceleration of health deficit accumulation in late-life: evidence of terminal decline in frailty index three years before death in the US Health and Retirement Study.
Ann Epidemiol. 2021; 58:156-161
Doi: 10.1016/j.annepidem.2021.03.008
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- Leading authors Med Uni Graz
- Stolz Erwin
- Co-authors Med Uni Graz
- Freidl Wolfgang
- Mayerl Hannes
- Roller-Wirnsberger Regina
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- Abstract:
- BACKGROUND: Little is known about within-person frailty index (FI) changes during the last years of life. In this study, we assess whether there is a phase of accelerated health deficit accumulation (terminal health decline) in late-life. MATERIAL AND METHODS: A total of 23,393 observations from up to the last 21 years of life of 5713 deceased participants of the AHEAD cohort in the Health and Retirement Study were assessed. A FI with 32 health deficits was calculated for up to 10 successive biannual, self- and proxy-reported assessments (1995-2014), and FI changes according to time-to-death were analyzed with a piecewise linear mixed model with random change points. RESULTS: The average normal (preterminal) health deficit accumulation rate was 0.01 per year, which increased to 0.05 per year at approximately 3 years before death. Terminal decline began earlier in women and was steeper among men. The accelerated (terminal) rate of health deficit accumulation began at a FI-value of 0.29 in the total sample, 0.27 for men, and 0.30 for women. CONCLUSION: We found evidence for an observable terminal health decline in the FI following declining physiological reserves and failing repair mechanisms. Our results suggest a conceptually meaningful cut-off value for the continuous FI around 0.30.
- Find related publications in this database (using NLM MeSH Indexing)
- Acceleration - administration & dosage
- Aged - administration & dosage
- Cohort Studies - administration & dosage
- Female - administration & dosage
- Frail Elderly - administration & dosage
- Frailty - epidemiology
- Geriatric Assessment - administration & dosage
- Humans - administration & dosage
- Male - administration & dosage
- Retirement - administration & dosage
- Find related publications in this database (Keywords)
- frailty
- geriatrics
- death
- aged
- aged 80 and over
- repeated rounds of survey