Recurrent Measurement of Frailty Is Important for Mortality Prediction: Findings from the North West Adelaide Health Study

Mark Q. Thompson, Olga Theou, Graeme R. Tucker, Robert J. Adams, Renuka Visvanathan

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)


OBJECTIVES: Frailty places individuals at greater risk of adverse health outcomes. However, it is a dynamic condition and may not always lead to decline. Our objective was to determine the relationship between frailty status (at baseline and follow-up) and mortality using both the frailty phenotype (FP) and frailty index (FI). DESIGN: Population-based cohort. SETTING: Community-dwelling older adults. PARTICIPANTS: A total of 909 individuals aged 65 years or older (55% female), mean age 74.4 (SD 6.2) years, had frailty measurement at baseline. Overall, 549 participants had frailty measurement at two time points. MEASUREMENTS: Frailty was measured using the FP and FI, with a mean 4.5 years between baseline and follow-up. Mortality was matched to official death records with a minimum of 10 years of follow-up. RESULTS: For both measures, baseline frailty was a significant predictor of mortality up to 10 years, with initially good predictive ability (area under the curve [AUC] =.8-.9) decreasing over time. Repeated measurement at follow-up resulted in good prediction compared with lower (AUC =.6-.7) discrimination of equivalent baseline frailty status. In a multivariable model, frailty measurement at follow-up was a stronger predictor of mortality compared with baseline. Frailty change for the Continuous FI was a significant predictor of decreased or increased mortality risk based on corresponding improvement or worsening of score (hazard ratio = 1.04; 95% confidence interval = 1.02-1.07; P =.001). CONCLUSIONS: Frailty measurement is a good predictor of mortality up to 10 years; however, recency of frailty measurement is important for improved prediction. A regular review of frailty status is required in older adults. J Am Geriatr Soc 67:2311–2317, 2019.

Original languageEnglish
Pages (from-to)2311-2317
Number of pages7
JournalJournal of the American Geriatrics Society
Issue number11
Publication statusPublished or Issued - 1 Nov 2019
Externally publishedYes


  • Australia
  • frailty
  • longitudinal study
  • mortality
  • older adults

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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