University of Oulu

Koivukangas, M., Hietikko, E., Strandberg, T. et al. The Prevalence of Frailty Using Three Different Frailty Measurements in Two Finnish Cohorts Born Before and After the Second World War. J Nutr Health Aging 25, 611–617 (2021).

The prevalence of frailty using three different frailty measurements in two Finnish cohorts born before and after the Second World War

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Author: Koivukangas, M. M.1,2,3; Hietikko, E.1,2,3; Strandberg, T.1,2,4;
Organizations: 1Center for Life Course Health Research, Geriatrics, University of Oulu, PO Box 5000, 90014, Oulu, Finland
2Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
3Oulu City Hospital, Oulu, Finland
4University of Helsinki, Helsinki, Finland
5Healthcare and Social Services of Selänne, Pyhäjärvi, Finland and Healthcare and Social Services of city of Oulu, Oulu, Finland
6Neuroscience Research Australia, Sydney, Australia
7University of New South Wales, Sydney, Australia
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 2.4 MB)
Persistent link:
Language: English
Published: Springer Nature, 2021
Publish Date: 2022-01-09


Objectives: To study the prevalence of frailty and its relationship to mortality in cohorts born before and after the Second World War using three different frailty measures.

Methods: Cross-sectional data from two cohorts born in 1935 (n=593) and 1945 (n=714) were studied for frailty at the mean age of 70.7 (SD 1.8) years. Frailty was measured using the Frailty Phenotype (FP), the Frail Scale (FS) and the 74-item Frailty Index (FI>0.21 denoted frailty). Information on socioeconomic factors was obtained via a study questionnaire and the data on mortality were obtained from the Population Information System.

Results: The prevalence of frailty by FI was more common in the older 1935 cohort than in the 1945 cohort (p<0.001). The percentage of robust subjects was higher in both sexes in the 1945 cohort using both FI and FS. After adjusting for sociodemographic factors, the difference in the prevalence of frailty between the cohorts remained significant in women only (OR 1.9 (95% CI 1.3–2.9), p=0.001). The FI classified people as frail more often (30.2% in the 1935 cohort and 17.5% in the 1945 cohort) than the FS (13.1% and 8.8%) or FP (1.8% and 1.6%). Low financial satisfaction was associated significantly with frailty in both sexes. Low level of education was associated with frailty in women and being unmarried or divorced in men. Frailty was associated to increased mortality using all frailty definitions in the 1935 cohort with a longer follow-up time.

Conclusions: Improved living conditions and health care may have resulted in the lower prevalence of frailty in the 1945 cohort. The present study further strengthens the association between frailty and mortality & poor economic status and frailty. Frailty definitions are in need of further study.

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Series: Journal of nutrition, health & aging
ISSN: 1279-7707
ISSN-E: 1760-4788
ISSN-L: 1279-7707
Volume: 25
Pages: 611 - 617
DOI: 10.1007/s12603-021-1586-6
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
3142 Public health care science, environmental and occupational health
Funding: This work was supported by grants from the Päivikki and Sakari Sohlberg Foundation and the Uulo Arhio Foundation and received state funding for health research from Oulu City Hospital.
Copyright information: © Serdi and Springer-Verlag International SAS, part of Springer Nature. This is a post-peer-review, pre-copyedit version of an article published in J Nutr Health Aging. The final authenticated version is available online at