Frailty, multimorbidity and mortality risk among octogenarian men

Background Multimorbidity and frailty phenotype are common among people aged 75 and older, but there is little data on their independent contributions to prognosis.

Methods In the Helsinki Businessmen Study, men born 1919–1934 were followed up from the 1960s. In 2011, multimorbidity, prefrailty and frailty phenotype were assessed in 528 home-living men (median age 82, interquartile range 80–86 years). Seven-year mortality was retrieved from the national register, and prognostic factors were analysed using Cox regression.

Results The following groups were identified: group I: robust without multimorbidity (n = 135; 25% dead); group II: only prefrailty (n = 177; 44% dead); group III: only frailty (n = 27; 70% dead); group IV: only multimorbidity (n = 59; 37% dead); group V: multimorbidity + prefrailty (n = 107; 56% dead); group VI: multimorbidity + frailty (n = 23; 83% dead). In an adjusted model including disability, hazard ratios (with 95% confidence interval) with group I as reference were: II: 2.01 (95% CI 1.26–3.20); III: 3.68 (1.88–7.20); IV: 1.81 (1.00–3.28); V: 2.63 (1.61–4.28); VI: 4.83 (2.47–9.45).

Conclusions Prefrailty and frailty phenotype predicted mortality similarly – or better – than multimorbidity and may thus provide extra prognostic value in older men.

Timo E. Strandberg, Satu Jyväkorpi, Annele Urtamo, Kaisu H. Pitkälä, Mika Kivimäki

Timo E. Strandberg

Professor emeritus

University of Helsinki, and Helsinki and Uusimaa Hospital District

University of Oulu