AEPI555D Lecture 2

1. Lecture 2: Disability and Frailty

2. Compression of morbidity and mortality
hypotheses

3. PNAS 2001 98: 6354-6359

4. PNAS 2001 98: 6354-6359

5. PNAS 2001 98: 6354-6359

9. N. Engl. J. Med. 2006; 355: 695 - 703.

10. N. Engl. J. Med. 2006; 355: 695 - 703.

12. Frailty: the next stage of chronic disease?

13. Hospitalization, Restricted Activity, and the
Development of Disability Among Older Persons
• Cohort
– March 1998 and October 1999
– potential participants were identified from a computerized list of 3157
age-eligible members from a large health plan in greater New Haven
– screening telephone interview
– in-home assessment.
• Physical frailty
– Timed score of greater than 10 seconds on the rapid gait test (ie, walk
back and forth over a 10-ft [3-m] course as quickly as possible)
– In the absence of a criterion standard, operationalizing physical frailty as
slow gait speed is justified by:
• High face validity
• Clinical feasibility
• Strong epidemiological link to functional decline and disability
JAMA. 2004;292:2115-2124

14. Gill, T. M. et al. JAMA 2004;292:2115-2124.
Baseline Characteristics of Study Participants*

15. Gill, T. M. et al. JAMA 2004;292:2115-2124.
Kaplan-Meier Curves for the Development of Disability

16. Gill, T. M. et al. JAMA 2004;292:2115-2124.
Exposure to Intervening Events per 100 Months According to Disability Status*

17. Gill, T. M. et al. JAMA 2004;292:2115-2124.
Factors Associated With the Development of Any Disability*

18. Gill, T. M. et al. JAMA 2004;292:2115-2124.
Association Between New Intervening Events and Disability According to Physical Frailty at
Baseline

19. Gill, T. M. et al. Arch Intern Med 2006;166:418-423.
Numbers and Rates of Transitions From Prefrail State at 18 Months to Subsequent State at 36
Months According to Baseline State*