Department of Statistics, Florida State University, Tallahassee, Florida, United States of America.
Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, United States of America.
PLoS One. 2018 Apr 10;13(4):e0195637. doi: 10.1371/journal.pone.0195637. eCollection 2018.
Frailty is a risk factor for disability and mortality, and is more prevalent among African American (AA) elderly than whites. We examine frailty in middle-aged racially and economically diverse adults, and investigate how race, poverty and frailty are associated with mortality. Data were from 2541 participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span study in Baltimore, Maryland; 35-64 years old at initial assessment (56% women; 58% AA). Frailty was assessed using a modified FRAIL scale of fatigue, resistance, ambulation, illness and weight loss, and compared with difficulties in physical functioning and daily activities. Frailty prevalence was calculated across race and age groups, and associations with survival were assessed by Cox Regression. 278 participants were frail (11%); 924 pre-frail (36%); 1339 not frail (53%). For those aged 45-54, a higher proportion of whites (13%) than AAs (8%) were frail; while the proportions were similar for those 55-64 (14%,16%). Frailty was associated with overall survival with an average follow-up of 6.6 years, independent of race, sex and poverty status (HR = 2.30; 95%CI 1.67-3.18). In this sample of economically and racially diverse older adults, the known association of frailty prevalence and age differed across race with whites having higher prevalence at younger ages. Frailty was associated with survival beyond the risk factors of race and poverty status in this middle-aged group. Early recognition of frailty at these younger ages may provide an effective method for preventing or delaying disabilities.
衰弱是残疾和死亡的一个风险因素，并且在非裔美国（AA）老年人中比白人更为普遍。我们研究了种族和经济背景多样的中年成年人的衰弱情况，并调查种族、贫困与衰弱如何与死亡率相关联。数据来自马里兰州巴尔的摩市开展的“全生命周期邻里健康老龄化”研究中的2541名参与者；初次评估时年龄在35 - 64岁之间（56%为女性；58%为非裔美国人）。使用疲劳、耐力、行走能力、疾病和体重减轻的改良FRAIL量表评估衰弱情况，并与身体功能和日常活动方面的困难进行比较。计算不同种族和年龄组的衰弱患病率，并通过Cox回归评估与生存的关联。278名参与者衰弱（11%）；924名处于衰弱前期（36%）；1339名不衰弱（53%）。对于45 - 54岁的人群，白人中衰弱的比例（13%）高于非裔美国人（8%）；而55 - 64岁人群的比例相似（分别为14%、16%）。在平均随访6.6年的情况下，衰弱与总体生存相关，且独立于种族、性别和贫困状况（风险比 = 2.
