Development and validation of a frailty index in the Longitudinal Aging Study Amsterdam

Abstract Background Baseline frailty index (FI) values have been shown to predict mortality among older adults, but little is known about the effects of changes in FI on mortality. Methods In a coordinated approach, we analyzed data from 4 population-based cohorts: the Health and Retirement Study (HRS), the Survey of Health, Ageing and Retirement in Europe (SHARE), the English Longitudinal Survey of Ageing (ELSA), and the Longitudinal Aging Study Amsterdam (LASA), comprising a total of 24 961 respondents (65+), 95 897 observations, up to 9 repeated FI assessments, and up to 23 years of mortality follow-up. The effect of time-varying FI on mortality was modeled with joint regression models for longitudinal and time-to-event data. Results Differences (of 0.01) in current FI levels (hazard ratio [HR] = 1.04, 95% credible interval [CI] = 1.03–1.05) and baseline FI levels (HR = 1.03, 95% CI = 1.03–1.05) were consistently associated with mortality across studies. Importantly, individuals with steeper FI growth also had a higher mortality risk: An increase in annual FI growth by 0.01 was associated with an increased mortality risk of HR = 1.56 (95% CI = 1.49–1.63) in HRS, HR = 1.24 (95% CI = 1.13–1.35) in SHARE, HR = 1.40 (95% CI = 1.25–1.52) in ELSA, and HR = 1.71 (95% CI = 1.46–2.01) in LASA. Conclusions FI changes predicted mortality independently of baseline FI differences. Repeated assessment of frailty and individual’s frailty trajectory could provide a means to anticipate further health deterioration and mortality and could thus support clinical decision making.

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Trends in Frailty and its Association with Mortality: Results From the Longitudinal Aging Study Amsterdam (1995-2016)

American Journal of Epidemiology ◽

10.1093/aje/kwab018 ◽

2021 ◽

Author(s):

Emiel O Hoogendijk ◽

Erwin Stolz ◽

Richard C Oude Voshaar ◽

Dorly J H Deeg ◽

Martijn Huisman ◽

...

Keyword(s):

Older Adults ◽

Frailty Index ◽

Estimating Equation ◽

Significant Interaction Effect ◽

Policy Makers ◽

Longitudinal Aging Study Amsterdam ◽

Aging Study ◽

Longitudinal Aging Study ◽

Stable Association ◽

Age Range

Abstract The aim of the current study was to investigate trends in frailty and its relationship with mortality among older adults aged 64-84 years across a period of 21 years. Data from 1995 to 2016 were used from the Longitudinal Aging Study Amsterdam. A total of 7,742 observations of 2,874 respondents in the same age range (64-84 years) across six measurement waves were included. Frailty was measured with a 32-item frailty index, with a cut-point of ≥0.25 to indicate frailty. The outcome measure was 4-year mortality. Generalized Estimating Equation analyses showed that among older adults aged 64-84 years the 4-year mortality rate declined between 1995 and 2016, while the prevalence of frailty increased. Across all measurement waves, frailty was associated with 4-year mortality (Odds Ratio: 2.79, 95% Confidence Interval: 2.39, 3.26). There was no statistically significant interaction effect between frailty and time on 4-year mortality, indicating a stable association between frailty and mortality. In more recent generations of older adults, frailty prevalence rates were higher, while excess mortality rates of frailty remained the same. This is important information for health policy makers and clinical practice, as it shows that continued efforts are needed to reduce frailty and its negative health consequences.

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Inequalities in Frailty Among Older Turkish and Moroccan Immigrants and Native Dutch: Data from the Longitudinal Aging Study Amsterdam

Journal of Immigrant and Minority Health ◽

10.1007/s10903-021-01169-9 ◽

2021 ◽

Author(s):

Emiel O. Hoogendijk ◽

Maaike E. Muntinga ◽

Sascha de Breij ◽

Martijn Huisman ◽

Silvia S. Klokgieters

Keyword(s):

Educational Level ◽

Frailty Index ◽

Country Of Origin ◽

Deficit Accumulation ◽

Cross Sectional ◽

Turkish Immigrants ◽

Older Immigrants ◽

Longitudinal Aging Study Amsterdam ◽

Aging Study ◽

Longitudinal Aging Study

AbstractVery few studies have investigated frailty among older immigrants in Europe. The aim of the current study was to investigate inequalities in frailty in young-olds related to gender, educational level and country of origin, as well as intersections between these characteristics. Cross-sectional data were used from older Turkish and Moroccan immigrants (n = 466) and native Dutch (n = 1,020), all aged 55–65 years and participating in the Longitudinal Aging Study Amsterdam. Frailty was assessed with a 30-item frailty index, based on the deficit accumulation approach. Frailty was higher among women, lower educated, and people with a migration background. Of all groups considered, frailty levels were the highest among Turkish immigrants. No statistically significant interaction effects between gender, educational level and country of origin were found. When targeting frailty interventions, special attention should be devoted to older immigrants, as they are the most vulnerable group with the highest frailty levels.

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Older adults report cancellation or avoidance of medical care during the COVID-19 pandemic: results from the Longitudinal Aging Study Amsterdam

European Geriatric Medicine ◽

10.1007/s41999-021-00514-3 ◽

2021 ◽

Author(s):

Noah A. Schuster ◽

Sascha de Breij ◽

Laura A. Schaap ◽

Natasja M. van Schoor ◽

Mike J. L. Peters ◽

...

Keyword(s):

Older Adults ◽

Primary Care ◽

Medical Care ◽

Help Seeking ◽

Community Dwelling ◽

Multiple Chronic Conditions ◽

Hospital Outpatient ◽

Longitudinal Aging Study Amsterdam ◽

Aging Study ◽

Longitudinal Aging Study

Abstract Purpose Delay of routine medical care during the COVID-19 pandemic may have serious consequences for the health and functioning of older adults. The aim of this study was to investigate whether older adults reported cancellation or avoidance of medical care during the first months of the COVID-19 pandemic, and to explore associations with health and socio-demographic characteristics. Methods Cross-sectional data of 880 older adults aged ≥ 62 years (mean age 73.4 years, 50.3% female) were used from the COVID-19 questionnaire of the Longitudinal Aging Study Amsterdam, a cohort study among community-dwelling older adults in the Netherlands. Cancellation and avoidance of care were assessed by self-report, and covered questions on cancellation of primary care (general practitioner), cancellation of hospital outpatient care, and postponed help-seeking. Respondent characteristics included age, sex, educational level, loneliness, depression, anxiety, frailty, multimorbidity and information on quarantine. Results 35% of the sample reported cancellations due to the COVID-19 situation, either initiated by the respondent (12%) or by healthcare professionals (29%). Postponed help-seeking was reported by 8% of the sample. Multimorbidity was associated with healthcare-initiated cancellations (primary care OR = 1.92, 95% CI = 1.09–3.50; hospital OR = 1.86, 95% CI = 1.28–2.74) and respondent-initiated hospital outpatient cancellations (OR = 2.02, 95% CI = 1.04–4.12). Depressive symptoms were associated with postponed help-seeking (OR = 1.15, 95% CI = 1.06–1.24). Conclusion About one third of the study sample reported cancellation or avoidance of medical care during the first months of the pandemic, and this was more common among those with multiple chronic conditions. How this impacts outcomes in the long term should be investigated in future research.

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Social network size, loneliness, physical functioning and depressive symptoms among older adults: examining reciprocal associations in four waves of the Longitudinal Aging Study Amsterdam (LASA)

International Journal of Geriatric Psychiatry ◽

10.1002/gps.5560 ◽

2021 ◽

Author(s):

Joan Domènech‐Abella ◽

Jordi Mundó ◽

Lise Switsers ◽

Theo van Tilburg ◽

Daniel Fernández ◽

...

Keyword(s):

Older Adults ◽

Social Network ◽

Depressive Symptoms ◽

Physical Functioning ◽

Network Size ◽

Social Network Size ◽

Longitudinal Aging Study Amsterdam ◽

Aging Study ◽

Longitudinal Aging Study ◽

Reciprocal Associations

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Predictors in starting and stopping Internet use between 2002 and 2012 by Dutch adults 65 years and older

Health Informatics Journal ◽

10.1177/1460458217720398 ◽

2017 ◽

Vol 25 (3) ◽

pp. 715-730 ◽

Cited By ~ 2

Author(s):

Jessica Berner ◽

Marja Aartsen ◽

Dorly Deeg

Keyword(s):

Older Adults ◽

Psychological Health ◽

Internet Use ◽

Cox Regression ◽

Demographic Predictors ◽

Longitudinal Aging Study Amsterdam ◽

Aging Study ◽

Longitudinal Aging Study ◽

Normal Cognition ◽

High Sense

Research has indicated the need to consider the ageing process with technology adoption by older adults. This study examined psychological, health, social and demographic predictors with starting and stopping Internet use by older adults (2002–2012). Data were used from the Longitudinal Aging Study Amsterdam, and Cox regression analyses were done to test predictors over time with starting or stopping Internet use. The results indicated that older adults starting to use the Internet (11.6%) outnumbered those who stopped (3.1%). Psychological, health, social and demographic predictors separately predicted starting and stopping Internet use. Starting use was predicted by lower age, higher education, normal cognition and living alone. The predictors in stopping use were being younger, having a high sense of mastery and being higher educated. The results need to be interpreted as indicative due to the small number of stoppers. Suggestions are made on how to improve usability.

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Hoe pakt de hogere AOW-leeftijd uit?

Tijdschrift voor Arbeidsvraagstukken ◽

10.5117/tva2021.2.002.deeg ◽

2021 ◽

Vol 37 (2) ◽

pp. 137-160

Author(s):

Dorly J.H. Deeg ◽

Mariska van der Horst ◽

Cécile R.L. Boot

Keyword(s):

Content Type ◽

Longitudinal Aging Study Amsterdam ◽

Aging Study ◽

Longitudinal Aging Study

Samenvatting Door de recente verhoging van de AOW-leeftijd in Nederland is een nieuwe groep ontstaan: de betaald werkenden tussen de oude AOW-leeftijd van 65 jaar en de nieuwe AOW-leeftijd, de ‘65-pre-AOW’ers’. In een eerste kenschets van deze groep vergelijken wij hun werk- en individuele kenmerken met die van de 61-64-jarige werkers, de ‘61-64’ers’, en de werkers boven de nieuwe AOW-leeftijd, de ‘post-AOW’ers’. In 2019 verschaften 764 61-70-jarige deelnemers aan de voor Nederland representatieve Longitudinal Aging Study Amsterdam gegevens over sociaal-demografische kenmerken, financiële situatie, gezondheid, werkcapaciteit en werkkenmerken. Het aandeel werkenden verschilde duidelijk naar leeftijd: 67% bij de 61-64’ers, 48% bij de 65-pre-AOW’ers en 16% bij de post-AOW’ers. Ook het gemiddeld aantal werkuren per week verschilde en bedroeg 31, 27 respectievelijk 18 uren. Voor de werkende 61-64’ers en 65-pre-AOW’ers was hun financiële situatie een belangrijke drijfveer om door te werken. De werkende 61-64’ers en 65-pre-AOW’ers hadden minder gezondheidsbeperkingen dan de werkende post-AOW’ers, maar de werkende post-AOW’ers rapporteerden een hogere werkcapaciteit. De werkende 65-pre-AOW’ers vormden een minderheid van hun leeftijdsgenoten. Om te bevorderen dat meer mensen tot de AOW-leeftijd doorwerken, zeker aangezien deze hoger wordt, zouden de arbeidsomstandigheden beter aangepast moeten worden aan de werkcapaciteit in deze leeftijdsgroep.

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