University of Oulu

Strandberg, T.E., Lindström, L., Jyväkorpi, S. et al. Phenotypic frailty and multimorbidity are independent 18-year mortality risk indicators in older men. Eur Geriatr Med 12, 953–961 (2021).

Phenotypic frailty and multimorbidity are independent 18-year mortality risk indicators in older men

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Author: Strandberg, Timo E.1,2; Lindström, Linda3; Jyväkorpi, Satu3;
Organizations: 1University of Helsinki, Clinicum, and Helsinki University Hospital, Haartmaninkatu 4, PO Box 340, 00029, Helsinki, Finland
2Center for Life Course Health Research, University of Oulu, Oulu, Finland
3University of Helsinki, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.8 MB)
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Language: English
Published: John Wiley & Sons, 2021
Publish Date: 2021-11-11


Purpose: Multimorbidity, prefrailty, and frailty are frequent in ageing populations, but their independent relationships to long-term prognosis in home-dwelling older people are not well recognised.

Methods: In the Helsinki Businessmen Study (HBS) men with high socioeconomic status (born 1919–1934, n = 3490) have been followed-up from midlife. In 2000, multimorbidity (≥ 2 conditions), phenotypic prefrailty and frailty were determined in 1365 home-dwelling men with median age of 73 years). Disability was assessed as a possible confounder. 18-year mortality follow-up was established from registers and Cox regression used for analyses.

Results: Of the men, 433 (31.7%) were nonfrail and without multimorbidity at baseline (reference group), 500 (36.6%) and 82 (6.0%) men had prefrailty or frailty, respectively, without multimorbidity, 84 (6.2%) men had multimorbidity only, and 201 (14.7%) and 65 (4.8%) men had prefrailty or frailty together with multimorbidity. Only 30 (2.2%) and 86 (6.3%) showed signs of ADL or mobility disability. In the fully adjusted analyses (including ADL disability, mental and cognitive status) of 18-year mortality, frailty without multimorbidity (hazard ratio 1.62, 95% confidence interval 1.13–2.31) was associated with similar mortality risk than multimorbidity without frailty (1.55, 1.17–2.06). The presence of both frailty and multimorbidity indicated a strong mortality risk (2.93, 2.10–4.07).

Conclusion: Although multimorbidity is generally considered a substantial health problem, our long-term observational study emphasises that phenotypic frailty alone, independently of disability, may be associated with a similar risk, and a combination of multimorbidity and frailty is an especially strong predictor of mortality.

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Series: European geriatric medicine
ISSN: 1878-7649
ISSN-E: 1878-7657
ISSN-L: 1878-7649
Volume: 12
Issue: 5
Pages: 953 - 961
DOI: 10.1007/s41999-021-00472-w
Type of Publication: A1 Journal article – refereed
Field of Science: 3141 Health care science
3142 Public health care science, environmental and occupational health
Funding: Open access funding provided by University of Helsinki including Helsinki University Central Hospital.
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