Elhussein, L., Robinson, D.E., Delmestri, A. et al. (4 more authors) (2024) Longitudinal trajectories of frailty are associated with short-term mortality in older people: a joint latent class models analysis using 2 UK primary care databases. Journal of Clinical Epidemiology, 173. 111442. ISSN 0895-4356
Abstract
Objectives Frailty is a dynamic health state that changes over time. Our hypothesis was that there are identifiable subgroups of the older population that have specific patterns of deterioration. The objective of this study was to evaluate the application of joint latent class model in identifying trajectories of frailty progression over time and their group-specific risk of death in older people. Study Design and Setting The primary care records of UK patients, aged over 65 as of January 1, 2010, included in the Clinical Practice Research Datalink: GOLD and AURUM databases, were analyzed and linked to mortality data. The electronic frailty index (eFI) scores were calculated at baseline and annually in subsequent years (2010-2013). Joint latent class model was used to divide the population into clusters with different trajectories and associated mortality hazard ratios. The model was built in GOLD and validated in AURUM. Results Five trajectory clusters were identified and characterized based on baseline and speed of progression: low–slow, low–moderate, low–rapid, high–slow, and high–rapid. The high–rapid cluster had the highest average starting eFI score; 7.9, while the low–rapid cluster had the steepest rate of eFI progression; 1.7. Taking the low–slow cluster as reference, low–rapid and high–rapid had the highest hazard ratios: 3.73 (95% CI 3.71, 3.76) and 3.63 (3.57-3.69), respectively. Good validation was found in the AURUM population. Conclusion Our research found that there are vulnerable subgroups of the older population who are currently frail or have rapid frailty progression. Such groups may be targeted for greater healthcare monitoring.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2024 The Author(s). This is an open access article under the terms of the Creative Commons Attribution License (CC-BY 4.0), which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited. |
Keywords: | Older people, Longitudinal, Frailty, Electronic frailty index, Mortality, Joint latent class models, Joint models |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Elderly Care and Rehabilitation (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 01 Nov 2024 09:42 |
Last Modified: | 01 Nov 2024 09:42 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.jclinepi.2024.111442 |
Related URLs: | |
Sustainable Development Goals: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:219094 |