Static and dynamic measures of frailty predicted decline in performance-based and self-reported physical functioning

Objective: To determine the effect of frailty on decline in physical functioning and to examine if chronic diseases modify this effect. Methods: The study sample was derived from the Longitudinal Aging Study Amsterdam and included respondents with initial ages 65 and over at T-2) (1995/1996), who participated at T-1 (1992/1993) and T-2 and performed physical performance tests (n = 1,152) or reported functional limitations (n = 1,321) at T-2 and T-3 (1998/1999). Nine frailty markers were determined in two ways: low functioning at T-2 (static definition); and decline in functioning between T-1 and T-2 (dynamic definition). Using logistic regression analyses, the effect of frailty was examined on change in physical functioning between T-2 and T-3, adjusting for sex, age, education, and additionally chronic diseases. Results: Static frailty was associated with performance decline only in the middle-old group (OR 2.43; 95% CI 1.23-4.80) and associated with decline in self-reported functioning (OR 2.44; 95% CI 1.77-3.36). Dynamic frailty was associated with decline in performance only in women (OR 1.72; 95% CI 1.11-2.67) and with self-reported functional decline (OR 1.77; 95% CI 1.29-2.43). These associations were independent of chronic diseases. Conclusion: Frailty is more strongly associated with self-reported functional decline in older persons than with performance decline. (c) 2005 Elsevier Inc. All rights reserved.