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Abstract
To investigate the prevalence of frailty in a Dutch elderly population and to identify adverse health outcomes associated with the frailty phenotype independent of the comorbidities. Cross-sectional and longitudinal analyses within the Rotterdam Study (the Netherlands), a prospective population-based cohort study in persons aged a parts per thousand yen55 years. Frailty was defined as meeting three or more of five established criteria for frailty, evaluating nutritional status, physical activity, mobility, grip strength and exhaustion. Intermediate frailty was defined as meeting one or two frailty criteria. Comorbidities were objectively measured. Health outcomes were assessed by means of questionnaires, physical examinations and continuous follow-up through general practitioners and municipal health authorities for mortality. Of 2,833 participants (median age 74.0 years, inter quartile range 9) with sufficiently evaluated frailty criteria, 163 (5.8 %) participants were frail and 1,454 (51.3 %) intermediate frail. Frail elderly were more likely to be older and female, to have an impaired quality of life and to have fallen or to have been hospitalized. 108 (72.0 %) frail participants had a parts per thousand yen2 comorbidities, compared to 777 (54.4 %) intermediate frail and 522 (44.8 %) non-frail participants. Adjusted for age, sex and comorbidities, frail elderly had a significantly increased risk of dying within 3 years (HR 3.4; 95 % CI 1.9-6.4), compared to the non-frail elderly. This study in a general Dutch population of community-dwelling elderly able to perform the frailty tests, demonstrates that frailty is common and that frail elderly are at increased risk of death independent of comorbidities.
Keywords
Frail elderly, Weight loss, Grip strength, Physical activity, Mortality, OLDER WOMEN, DESIGN UPDATE, DISABILITY, MORTALITY, PEOPLE, DISEASE, INDEXES, FALLS, OBJECTIVES, PREVALENCE

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MLA
Lahousse, Lies, Bastiaan Maes, Gijsbertus Ziere, et al. “Adverse Outcomes of Frailty in the Elderly: The Rotterdam Study.” EUROPEAN JOURNAL OF EPIDEMIOLOGY 29.6 (2014): 419–427. Print.
APA
Lahousse, L., Maes, B., Ziere, G., Loth, D. W., Verlinden, V. J., Zillikens, M. C., Uitterlinden, A. G., et al. (2014). Adverse outcomes of frailty in the elderly: the Rotterdam study. EUROPEAN JOURNAL OF EPIDEMIOLOGY, 29(6), 419–427.
Chicago author-date
Lahousse, Lies, Bastiaan Maes, Gijsbertus Ziere, Daan W Loth, Vincentius JA Verlinden, M Carola Zillikens, André G Uitterlinden, et al. 2014. “Adverse Outcomes of Frailty in the Elderly: The Rotterdam Study.” European Journal of Epidemiology 29 (6): 419–427.
Chicago author-date (all authors)
Lahousse, Lies, Bastiaan Maes, Gijsbertus Ziere, Daan W Loth, Vincentius JA Verlinden, M Carola Zillikens, André G Uitterlinden, Fernando Rivadeneira, Henning Tiemeier, Oscar H Franco, M Arfan Ikram, Albert Hofman, Guy Brusselle, and Bruno H Stricker. 2014. “Adverse Outcomes of Frailty in the Elderly: The Rotterdam Study.” European Journal of Epidemiology 29 (6): 419–427.
Vancouver
1.
Lahousse L, Maes B, Ziere G, Loth DW, Verlinden VJ, Zillikens MC, et al. Adverse outcomes of frailty in the elderly: the Rotterdam study. EUROPEAN JOURNAL OF EPIDEMIOLOGY. 2014;29(6):419–27.
IEEE
[1]
L. Lahousse et al., “Adverse outcomes of frailty in the elderly: the Rotterdam study,” EUROPEAN JOURNAL OF EPIDEMIOLOGY, vol. 29, no. 6, pp. 419–427, 2014.
@article{5771952,
  abstract     = {To investigate the prevalence of frailty in a Dutch elderly population and to identify adverse health outcomes associated with the frailty phenotype independent of the comorbidities. Cross-sectional and longitudinal analyses within the Rotterdam Study (the Netherlands), a prospective population-based cohort study in persons aged a parts per thousand yen55 years. Frailty was defined as meeting three or more of five established criteria for frailty, evaluating nutritional status, physical activity, mobility, grip strength and exhaustion. Intermediate frailty was defined as meeting one or two frailty criteria. Comorbidities were objectively measured. Health outcomes were assessed by means of questionnaires, physical examinations and continuous follow-up through general practitioners and municipal health authorities for mortality. Of 2,833 participants (median age 74.0 years, inter quartile range 9) with sufficiently evaluated frailty criteria, 163 (5.8 %) participants were frail and 1,454 (51.3 %) intermediate frail. Frail elderly were more likely to be older and female, to have an impaired quality of life and to have fallen or to have been hospitalized. 108 (72.0 %) frail participants had a parts per thousand yen2 comorbidities, compared to 777 (54.4 %) intermediate frail and 522 (44.8 %) non-frail participants. Adjusted for age, sex and comorbidities, frail elderly had a significantly increased risk of dying within 3 years (HR 3.4; 95 % CI 1.9-6.4), compared to the non-frail elderly. This study in a general Dutch population of community-dwelling elderly able to perform the frailty tests, demonstrates that frailty is common and that frail elderly are at increased risk of death independent of comorbidities.},
  author       = {Lahousse, Lies and Maes, Bastiaan and Ziere, Gijsbertus and Loth, Daan W and Verlinden, Vincentius JA and Zillikens, M Carola and Uitterlinden, André G and Rivadeneira, Fernando and Tiemeier, Henning and Franco, Oscar H and Ikram, M Arfan and Hofman, Albert and Brusselle, Guy and Stricker, Bruno H},
  issn         = {0393-2990},
  journal      = {EUROPEAN JOURNAL OF EPIDEMIOLOGY},
  keywords     = {Frail elderly,Weight loss,Grip strength,Physical activity,Mortality,OLDER WOMEN,DESIGN UPDATE,DISABILITY,MORTALITY,PEOPLE,DISEASE,INDEXES,FALLS,OBJECTIVES,PREVALENCE},
  language     = {eng},
  number       = {6},
  pages        = {419--427},
  title        = {Adverse outcomes of frailty in the elderly: the Rotterdam study},
  url          = {http://dx.doi.org/10.1007/s10654-014-9924-1},
  volume       = {29},
  year         = {2014},
}

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