Frailty, fitness and late-life mortality in relation to chronological and biological age

Abstract

Abstract Background People age at remarkably different rates, but how to estimate trajectories of senescence is controversial. Methods In a secondary analysis of a representative cohort of Canadians aged 65 and over (n = 2914) we estimated a frailty index based on the proportion of 20 deficits observed in a structured clinical examination. The construct validity of the index was examined through its relationship to chronological age (CA). The criterion validity was examined in its ability to predict mortality, and in relation to other predictions about aging. From the frailty index, relative (to CA) fitness and frailty were estimated, as was an individual's biological age. Results The average value of the frailty index increased with age in a log-linear relationship (r = 0.91; p i.e. the average accumulation of deficits) amongst those with no cognitive impairment was 3 per cent per year. Conclusions The frailty index is a sensitive predictor of survival. As the index includes items not traditionally related to adverse health outcomes, the finding is compatible with a view of frailty as the failure to integrate the complex responses required to maintain function.