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Research on Aging
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Article

Dynamics of Frailty and ADL Dependence in a Five-Year Longitudinal Study of Octogenarians

Edith Guilley1*, Paolo Ghisletta1, Franca Armi1, André Berchtold2, Christian Lalive d'Epinay1, Jean-Pierre Michel3, and Anik de Ribaupierre4

1 University of Geneva
2 University of Lausanne
3 University Hospital of Geneva
4 University of Geneva, University of Lausanne

* To whom correspondence should be addressed. E-mail: edith.guilley{at}cig.unige.ch.


  Abstract
Using a sample of octogenarians from the Swiss Interdisciplinary Longitudinal Study on the Oldest Old, the authors investigated the predictive validity of an expanded working definition of frailty based on deficiencies in mobility, memory, energy, and physical or sensory capacities and analyzed the resulting health transitions. The five domains were considered as predictors of the onset of dependence in activities of daily living (ADLs) and death using logistic multilevel and Cox survival regression models. Health transitions were studied with Markov chains. Deficiencies in memory, energy, and sensory capacities contributed to the prediction of the onset of ADL dependence and death in participants free of physical pains and mobility impairments. With two domains affected, frailty in very old persons indicated an increased risk of adverse outcomes. The study of transitions showed that ADL-independent frailty was a highly probable and relatively long transitional stage between robustness and ADL dependence.

First published on January 31, 2008, doi:10.1177/0164027507312115

Research on Aging 2008;30:299.

A more recent version of this article appeared on May 1, 2008

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