Frailty, Vulnerability, and Disability in the Older Adult Population: The Health and Retirement Study

Christine Cigolle, University of Michigan
Mary Beth Ofstedal, University of Michigan
Zhiyi Tian, University of Michigan
Caroline Blaum, University of Michigan

Frailty (a geriatric condition indicating susceptibility to stressors) is postulated to be distinct from diseases and disability in characterizing the health status of the older adult population. We performed secondary data analysis of the 2004 and 2006 waves of the Health and Retirement Study, a nationally representative health interview survey. Our study sample included respondents ≥65 years old who completed physical performance tests (grip strength, walk speed) (n=1,657, representing 28.2 million). We examined two models of frailty (Fried, Strawbridge) and compared them to a clinical model of vulnerability (Assessing Care of Vulnerable Elders [ACOVE]). Demographic determinants of frailty/vulnerability for all three models included age, female gender, and decreased net worth. Controlling for demographic characteristics and chronic diseases using multivariable logistic regression, each frailty/vulnerability model predicted two-year disability (incidence/progression of dependency in basic and instrumental activities of daily living): Fried: adjusted odds ratio 3.2 (P<.0001), Strawbridge: 2.0 (P<.01), ACOVE: 2.3 (P<.001).