Table 3.
Clinical Outcomes by Frailty Markers
| Models | Frailty Score, Per Unit Increase | Frail | Physical Inactivity | Slowness/Weakness | Poor Endurance/Exhaustion | Malnutrition |
|---|---|---|---|---|---|---|
| All-cause mortality—Cox HR (95% CI) | ||||||
| Events | 273 | 273 | 397 | 283 | 281 | 499 |
| Participants/visits | 985/2,154 | 985/2,154 | 985/2,949 | 985/2,193 | 985/2,203 | 985/3,324 |
| Age-sex adjusted | 1.57 (1.39-1.76) | 1.87 (1.39-2.53) | 1.75 (1.43-2.14) | 3.50 (2.18-5.62) | 1.37 (1.05-1.79) | 1.20 (0.77-1.87) |
| Fully adjusteda | 1.58 (1.39-1.80) | 1.73 (1.26-2.38) | 1.74 (1.41-2.14) | 2.92 (1.79-4.76) | 1.29 (0.97-1.71) | 1.02 (0.64-1.61) |
| Adjustment for age, sex and number of comorbidities | 1.52 (1.35-1.72) | 1.73 (1.28-2.34) | 1.69 (1.38-2.07) | 3.07 (1.90-4.95) | 1.31 (1.003-1.71) | 1.24 (0.80-1.93) |
| Fully adjusted, with multiple imputationa | 1.23 (1.12-1.36) | 1.29 (1.02-1.64) | 1.55 (1.27-1.89) | 1.55 (1.12-2.14) | 1.13 (0.90-1.43) | – |
| All-cause hospitalizations—negative binomial RR (95% CI) | ||||||
| Events | 2,045 | 2,045 | 3,031 | 2,087 | 2,098 | 3,526 |
| Participants/visits | 985/2,154 | 985/2,154 | 985/2,949 | 985/2,193 | 985/2,203 | 985/3,324 |
| Age-sex adjusted | 1.22 (1.15-1.29) | 1.59 (1.36-1.86) | 1.15 (1.03-1.30) | 1.84 (1.49-2.27) | 1.36 (1.16-1.58) | 1.14 (0.67-1.95) |
| Fully adjusteda | 1.16 (1.09-1.23) | 1.40 (1.21-1.63) | 1.10 (0.98-1.23) | 1.58 (1.31-1.91) | 1.18 (1.02-1.36) | 1.10 (0.69-1.75) |
| Adjustment for age, sex and number of comorbidities | 1.18 (1.11-1.26) | 1.48 (1.27-1.73) | 1.12 (1.0004-1.26) | 1.67 (1.36-2.05) | 1.28 (1.10-1.49) | 1.12 (0.68-1.85) |
| Fully adjusted, with multiple imputationa | 1.09 (1.03-1.15) | 1.21 (1.06-1.39) | 1.08 (0.97-1.21) | 1.30 (1.09-1.54) | 1.08 (0.94-1.23) | – |
| Long-term care placement—Cox HR (95% CI) | ||||||
| Events | 61 | 61 | 95 | 61 | 61 | 114 |
| Participants/visits | 943/2,033 | 943/2,033 | 949/2,775 | 943/2,069 | 943/2,078 | 951/3,098 |
| Age-sex adjusted | 1.63 (1.24-2.14) | 3.34 (1.51-7.40) | 1.32 (0.86-2.01) | 2.97 (1.06-8.31) | 2.26 (1.17-4.39) | 1.12 (0.41-3.03) |
| Adjustment for age, sex and number of comorbidities | 1.61 (1.22-2.12) | 3.20 (1.44-7.12) | 1.29 (0.84-1.96) | 2.76 (0.98-7.78) | 2.18 (1.12-4.24) | 1.11 (0.41-3.01) |
| Adjustment for age, sex and number of comorbidities, with multiple imputation | 1.22 (0.99-1.51) | 1.79 (1.03-3.09) | 1.22 (0.82-1.84) | 1.51 (0.74-3.09) | 1.48 (0.89-2.47) | – |
Note: Frailty data were allowed to vary at baseline, month 6, and year1, 2, and 5 visits. No other covariates were allowed to vary across time.
Abbreviations: AMI, acute myocardial infarction; BMI, body mass index; CHF, chronic heart failure; CI, confidence interval; COPD, chronic obstructive pulmonary disease; FT, full-time; GN, glomerulonephritis; HR, hazard ratio; MI, multiple imputation; NA, not available; PCKD, polycystic kidney disease; PT, part-time; PVD, peripheral vascular disease; RR, rate ratio.
The fully adjusted model was adjusted for baseline age (<40, 40-64, 65-79, ≥80 years), sex, newcomer status, ethnicity (White, indigenous, other), residence status (with family or friends, alone, assisted living/nursing home), employment status (employed FT or FT student or retiree, employed PT or PT student or homemaker or other, on disability, never employed or currently unemployed), smoking status, BMI (<18.5, 18.5-<26, 26-35, ≥35 kg/m2), primary cause of end-stage kidney disease (diabetic nephropathy, renal vascular disease, GN, PCKD, other), atrial fibrillation, AMI, CHF, hypertension, PVD, dementia, cerebrovascular accident, diabetes, chronic lung disease (including COPD), cancer, chronic liver disease, psychiatric illness, and substance misuse.