A Cross-Sectional Analysis of County-Level Social Vulnerability and Physical Frailty Among Adults with Hematological Malignancies

Abstract Introduction Physically frail older adults with hematological malignancies experience greater treatment-related toxicity, higher rates of treatment non-completion, increased utilization of health care services, and shorter overall survival than younger and fitter patients. For frail adults, living in areas of high social vulnerability may also place them at disproportionately higher risk of experiencing poor health outcomes. Yet, the association between community-level social vulnerability and physical frailty among patients with hematological malignancies has not been previously described. Methods We used a previously developed frailty index [Carolina Frailty Index (CFI)] (Guerard et al., 2017) of accumulated health deficits, derived from geriatric assessment data of participants enrolled in the Carolina Senior Registry (CSR) (ClinicalTrials.gov identifier: NCT01137825) at the University of North Carolina at Chapel Hill or the Registry for Adults with Plasma Cell Disorders (ClinicalTrials.gov identifier: NCT03717844). In this cross-sectional study, we examined the association between county-level social vulnerability [Centers for Disease Control Social Vulnerability Index (CDC SVI)] (https://www.atsdr.cdc.gov/placeandhealth/svi/data_documentation_download.html. Accessed on July 1, 2021) and physical frailty in adults with hematological malignancies enrolled in the registries. In a cohort of 338 patients (CFI score range, 0-1), patients with a CFI score of 0.2 or above were considered frail. Social vulnerability was measured using participant residential zip codes and county locations linked to the overall SVI and each of the four domains: 1, socioeconomic status; 2, household composition & disability; 3, minority status & language, and 4, housing & transportation, that comprise the overall SVI (score range 0-1, with 1= most vulnerable). We used cut points of 0.2, 0.4, 0.6, and 0.8 to stratify the level of social vulnerability. Associations were made using Jonkherre-Terpstra tests for trends. All analyses were performed using SAS version 9.4 (SAS Institute, Inc). All tests were 2-sided, and p < 0.05 was considered statistically significant. Results Among 338 patients [51% male, 70% aged ≥ 70 years (median age 72.5 years) 84% White], multiple myeloma was the most common cancer type (45%), followed by lymphoma (30%) and leukemia (23%). Overall, 52% (n=177) of patients were considered frail. Just over half of the sample (53%, 179/338) lived in a county with an SVI <0.2, indicating the least social vulnerability. Only 6.5% (22/338) of the patients lived in counties with the highest social vulnerability (SVI score 0.8 to 1.0). Baseline demographics for the overall cohort and according to SVI levels are summarized in Table 1. Significant differences in race and education were seen across SVI levels (both p<0.001). In general, the proportion of patients categorized as frail increased with increasing levels of social vulnerability. These trends for overall SVI (p=0.01), the socioeconomic status (SES) (p=0.005), and the housing & transportation (p=0.048) domains (Figure 1) were statistically significant. As an example, for the overall SVI, the frailty rate was 73% (16/22) for patients residing in the most vulnerable counties (SVI score 0.8 to 1.0) compared to 45% (81/179) for patients residing in counties with the least social vulnerability (SVI score < 0.2). Similar differences were observed for SES (68% vs 47%) and housing & transportation (66% vs 54%). Conclusion Among older adults with hematological malignancies, those residing in areas of high social vulnerability were more likely to be physically frail. These findings suggest that external, contextual factors significantly influence an individual's overall health and highlight the need for further work in this area. Future research should examine community social vulnerability as a risk factor for physical frailty development in adults; information could then be leveraged to identify those at greatest risk for functional losses and frailty onset. Through early identification of this subset of patients, preventative strategies and interventions could be developed, and resources allocated to help those considered most vulnerable. Figure 1 Figure 1. Disclosures Rubinstein: Sanofi: Consultancy; Roche: Consultancy. Wildes: Sanofi: Consultancy; Seattle Genetics: Consultancy; Carevive: Consultancy; Janssen: Consultancy. Tuchman: Caelum: Consultancy, Research Funding; Sanofi / Genzyme: Consultancy, Research Funding; Shattuck Labs: Consultancy; Karyopharm: Research Funding; Oncopeptides: Consultancy.

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Polypharmacy and Lack of Joy Are Related to Physical Frailty among Northern Japanese Community-Dwellers from the ORANGE Cohort Study

Gerontology ◽

10.1159/000511986 ◽

2021 ◽

pp. 1-10

Author(s):

Yu Kume ◽

Tomoko Takahashi ◽

Yuki Itakura ◽

Sangyoon Lee ◽

Hyuma Makizako ◽

...

Keyword(s):

Older Adults ◽

Rural Areas ◽

Assessment Tool ◽

Frailty Index ◽

Limited Information ◽

Physical Frailty ◽

Cross Sectional ◽

Explanatory Variables ◽

Frailty Status ◽

Community Dwellers

Introduction: A prevalence of frailty is gradually increasing with the progress of aging in Japan, and critical challenges regarding early diagnosis and prevention of frailty were necessary in community. Although previous studies have well documented the characteristics of physical disability, there is limited information on frail state differences among older adults in Japanese rural areas. The aim of our cross-sectional observational study was to clarify the association of frail status in northern Japanese community-dwellers aged 65 or more. Methods: 345 participants were recruited from 2018 to 2020, and after getting informed consent from each participant, assessments and outcomes were evaluated according to the ORANGE protocol. We applied the frailty index of Gerontology-the Study of Geriatric Syndromes (NCGG-SGS) to classify frailty status by collecting data of demographics and psychosocial status using the Kihon checklist (KCL) and cognitive domains used by the National Center for Geriatrics and Gerontology-Functional Assessment Tool (NCGG-FAT). Results: Our subjects included 313 older adults divided into 138 robust, 163 prefrail, and 12 frail. For statistical analysis, we found that the frail group had a lower educational duration, worsened KCL items, lower cognitive functions, and a tendency toward depression compared to the other groups. Moreover, physical frailty and cognitive decline were related, and polypharmacy and a lack of joy in daily life were explanatory variables of frail status. Conclusions: We suggest that KCL is important for frail discrimination, and in order to prevent physical frailty, our community should take care of not only exercise and nutrition but also cognitive functioning and depressive tendencies. In particular, polypharmacy and the presence of fun in your life are possible to be related to frailty.

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Prevalence of frailty in older adults in outpatient physiotherapy in an urban region in the western part of Germany: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-027768 ◽

2019 ◽

Vol 9 (6) ◽

pp. e027768 ◽

Cited By ~ 2

Author(s):

Tobias Braun ◽

Christian Thiel ◽

Carina Ziller ◽

Julia Rasche ◽

Carolin Bahns ◽

...

Keyword(s):

Older Adults ◽

Frailty Index ◽

Cross Sectional Study ◽

Secondary Outcome ◽

Urban Region ◽

Sectional Study ◽

Physical Frailty ◽

Frailty Phenotype ◽

Cross Sectional ◽

Age Related

ObjectiveTo investigate the prevalence of frailty in older people in outpatient physiotherapy services in an urban region in the western part of Germany.DesignCross-sectional study.SettingOutpatient physiotherapy clinics were recruited in the municipal area of the city of Bochum, Germany, and selected randomly.ParticipantsOlder adults aged 65 years and older seeking outpatient physiotherapy.Primary and secondary outcome measuresPrevalence of frailty was assessed based on the frailty phenotype model of physical frailty and the accumulation of deficit model, expressed as a Frailty Index. Prevalence was calculated for the whole sample and according to age-related, sex-related and diagnosis-related subgroups.ResultsA total of 258 participants (74±6 years, 62% female) from 11 out of 130 (8%) different physiotherapy clinics were included. Participants’ main indication for physiotherapy was an orthopaedic or surgical condition (75%). According to the model of a physical frailty phenotype, 17.8% (95% CI 13.2 to 22.5) participants were frail and 43.4% (95% CI 37.4 to 49.5) were prefrail. The Frailty Index identified 31.0% (95% CI 25.4 to 36.7) of individuals as frail. In both models, prevalence increased with age and was higher in women than in men. Slow gait speed (34%), reduced muscle strength (34%) and exhaustion (28%) were the most prevalent indicators of physical frailty.ConclusionsFrailty is comparatively common in older patients attending physiotherapy care in Germany, with one out of three individuals being frail and every second individual being physically frail or prefrail.Trial registration numberDRKS00009384; Results.

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Dairy Product Intake and Long-Term Risk for Frailty among French Elderly Community Dwellers

Nutrients ◽

10.3390/nu13072151 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2151

Author(s):

Berna Rahi ◽

Hermine Pellay ◽

Virginie Chuy ◽

Catherine Helmer ◽

Cecilia Samieri ◽

...

Keyword(s):

Older Adults ◽

Dairy Product ◽

Food Group ◽

Community Dwelling ◽

Physical Frailty ◽

Frailty Phenotype ◽

Cross Sectional ◽

Sectional Analysis ◽

Community Dwelling Older Adults

Dairy products (DP) are part of a food group that may contribute to the prevention of physical frailty. We aimed to investigate DP exposure, including total DP, milk, fresh DP and cheese, and their cross-sectional and prospective associations with physical frailty in community-dwelling older adults. The cross-sectional analysis was carried out on 1490 participants from the Three-City Bordeaux cohort. The 10-year frailty risk was examined in 823 initially non-frail participants. A food frequency questionnaire was used to assess DP exposure. Physical frailty was defined as the presence of at least 3 out of 5 criteria of the frailty phenotype: weight loss, exhaustion, slowness, weakness, and low physical activity. Among others, diet quality and protein intake were considered as confounders. The baseline mean age of participants was 74.1 y and 61% were females. Frailty prevalence and incidence were 4.2% and 18.2%, respectively. No significant associations were observed between consumption of total DP or DP sub-types and frailty prevalence or incidence (OR = 1.40, 95%CI 0.65–3.01 and OR = 1.75, 95%CI 0.42–1.32, for a total DP consumption >4 times/d, respectively). Despite the absence of beneficial associations of higher DP consumption on frailty, older adults are encouraged to follow the national recommendations regarding DP.

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Association between Physical Frailty Subdomains and Oral Frailty in Community-Dwelling Older Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062931 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2931

Author(s):

Ryo Komatsu ◽

Koutatsu Nagai ◽

Yoko Hasegawa ◽

Kazuki Okuda ◽

Yuto Okinaka ◽

...

Keyword(s):

Older Adults ◽

Gait Speed ◽

Community Dwelling ◽

Health Study ◽

Cardiovascular Health Study ◽

Physical Frailty ◽

Cross Sectional ◽

Important Indicator ◽

Community Dwelling Older Adults ◽

Oral Frailty

This cross-sectional study aimed to demonstrate the association between physical frailty subdomains and oral frailty. This study involved community-dwelling older adults (aged ≥65 years). Physical frailty was assessed with the Japanese version of the Cardiovascular Health Study criteria. Oral frailty was defined as limitations in at least three of six domains. Logistic regression analysis was used to analyze the association between physical frailty risk and oral frailty. In addition, we examined the association between physical frailty subdomains (gait speed, grip strength, exhaustion, low physical activity, and weight loss) and oral frailty. A total of 380 participants were recruited for this study. Overall, 18% and 14% of the participants were at risk of physical frailty and had oral frailty, respectively. Physical frailty risk (odds ratio (OR) = 2.40, 95% confidence interval (CI): 1.22–4.75, p = 0.012) was associated with oral frailty in multivariate analysis. In secondary analysis, among physical frailty subdomains, gait speed (OR = 0.85, 95% CI: 0.73–0.97, p = 0.019) was associated with oral frailty. The present findings suggest that physical frailty is closely related to oral frailty. Among physical frailty subdomains, decreased gait speed in particular is an important indicator related to the development of oral frailty.

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Social vulnerability and clinical trial access for older adults with myeloma in North Carolina.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18540 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18540-e18540

Author(s):

Shakira Jeanene Grant ◽

Matthew Jansen ◽

Sascha Tuchman ◽

Samuel M. Rubinstein ◽

Eben I. Lichtman ◽

...

Keyword(s):

Clinical Trial ◽

Socioeconomic Status ◽

North Carolina ◽

Social Vulnerability ◽

Household Composition ◽

Comprehensive Cancer Center ◽

County Level ◽

Phase 2 ◽

Financial Barriers ◽

Trial Site

e18540 Background: Multiple myeloma (MM) is a disease of aging, associated with one of the greatest black-white disparities in incidence and mortality among all US cancer types. Clinical trials provide the critical evidence-base to inform clinical management in all cancers, including MM. However, clinical trial participants are often younger (age < 65 years) and white, limiting the generalizability of published data to real-world MM care. Although geographical and financial barriers to clinical trial participation are well recognized, less is known about the association of county-level social vulnerability with MM trial availability. We examined county-level variation in the number of registered myeloma trials per 10,000 North Carolina (NC) residents age ≥ 65 years as a function of social vulnerability and the presence of a National Cancer Institute Comprehensive Cancer Center (CCC). Methods: We conducted a cross-sectional study using data from ClinicalTrials.gov to identify all registered interventional myeloma trials involving adults age ≥ 65 years with sites in NC. Records were downloaded on January 24th, 2021. This strategy yielded 456 non-unique NC sites for 223 trials. We obtained county locations for all trial sites by matching city, zip code, or institution name. We obtained NC population data for residents age ≥ 65 years (in 2019) from the American Community Survey. The four themes (socioeconomic status, household composition, ethnic and racial minority status/language, housing/transportation) within the Centers for Disease Control Social Vulnerability Index (CDC SVI) (composite score: 0-1, with a higher number indicating more vulnerability) were used to characterize county-level social vulnerability. We performed negative binomial regression and tabulations using R, version 3.6.1. A p-value < 0.05 was considered statistically significant. Results: Across 100 counties in NC, trial site counts by county per 10,000 residents age ≥ 65 years ranged from 0 to 23.2 (mean: 1.5, median: 0; IQR, 0-0.7). Controlling for the 4 SVI themes, counties with CCCs (Durham, Forsyth, Orange) had 77% more trials than those without CCCs [Incidence Rate Ratio (IRR): 7.74; p = 0.05]. We observed a 3.3% reduction in trial counts with each percentile increase in socioeconomic vulnerability (IRR: 0.97; p = 0.008). Counties with higher representation by racial and ethnic minorities had similar trial site counts to counties with lower minority populations (IRR: 1.01; p = 0.08). Sub-group analyses of early-stage studies (phase 1/2 and phase 2; n = 268) and late-stage studies (phase 2/3 and phase 3; n = 168) were similar. Conclusions: Our preliminary results suggest county-level socioeconomic status is associated with the distribution of MM clinical trial sites across NC. Further work is planned to explore whether additional variances in trial distribution could be explained by site- and study-specific characteristics.

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44 Association between Falls and Cognitive Frailty among Community Dwelling Older Adults: A Cross Sectional Study

Age and Ageing ◽

10.1093/ageing/afz164.44 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv9-iv12

Author(s):

Resshaya Roobini Murukesu ◽

Devinder Kaur Ajit Singh ◽

Noor Izyani Mokhtar ◽

Janet Bong May Ing ◽

Ponnusamy Subramaniam ◽

...

Keyword(s):

Older Adults ◽

Rating Scale ◽

Frailty Index ◽

Cross Sectional Study ◽

Community Dwelling ◽

Sectional Study ◽

Cross Sectional ◽

Cognitive Frailty ◽

Prospective Longitudinal ◽

Community Dwelling Older Adults

Abstract Introduction The presence of either frailty or cognitive impairment have been determined as precursors of falls among older adults. However, the association between falls and cognitive frailty has yet to be established. Objective To investigate the association between falls and cognitive frailty among community dwelling older adults. Methods A total of 246 Malaysian community dwelling older adults aged 60 years and above residing in the state of Selangor participated in this cross-sectional study. Sociodemographic details and clinical characteristics including the history of falls were obtained via interview. The presence of cognitive frailty was identified using the Clinical Dementia Rating Scale and Fried Frailty Index. Data analysis was carried out via binary logistic regression. Results The prevalence of falls and cognitive frailty in this study were 21.2% and 21.9% respectively among community dwelling older adults (mean age 72.39±5.40). No significant relationship between falls and cognitive frailty [OR:1.187, 95% C.I: 0.493-2.856, p=0.702] was demonstrated. However, older women [OR:2.663, 95% C.I, 1.136-6.239, p=0.024] and the presence of multi-morbidities [OR: 1.431, 95% C.I, 1.026-1.997, p=0.035] were significantly associated with falls which corroborates with existing literature. Conclusion Cognitive frailty was not a significant risk factor of falls among community dwelling older adults in this study. Further research is required in prospective, longitudinal, population-based studies to confirm this result.

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Is there an association between ageist attitudes and frailty?

BMC Geriatrics ◽

10.1186/s12877-019-1357-y ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Douglas Salguero ◽

Juliana Ferri-Guerra ◽

Nadeem Y. Mohammed ◽

Dhanya Baskaran ◽

Raquel Aparicio-Ugarriza ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Multinomial Logistic Regression ◽

Frailty Index ◽

Cross Sectional Study ◽

Community Dwelling ◽

Outcome Variable ◽

Cross Sectional ◽

Logistic Regression Models ◽

Frailty Status

Abstract Background Frailty is defined as a state of vulnerability to stressors that is associated with higher morbidity, mortality and healthcare utilization in older adults. Ageism is “a process of systematic stereotyping and discrimination against people because they are old.” Explicit biases involve deliberate or conscious controls, while implicit bias involve unconscious processes. Multiple studies show that self-directed ageism is a risk factor for increased morbidity and mortality. The purpose of this study was to determine whether explicit ageist attitudes are associated with frailty in Veterans. Methods This is a cross-sectional study of Veterans 50 years and older who completed the Kogan’s Attitudes towards Older People Scale (KAOP) scale to assess explicit ageist attitudes and the Implicit Association Test (IAT) to evaluate implicit ageist attitudes from July 2014 through April 2015. We constructed a frailty index (FI) of 44 variables (demographics, comorbidities, number of medications, laboratory tests, and activities of daily living) that was retrospectively applied to the time of completion of the KAOP and IAT. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by multinomial logistic regression models with frailty status (robust, prefrail and frail) as the outcome variable, and with KAOP and IAT scores as the independent variables. Age, race, ethnicity, median household income and comorbidities were considered as covariates. Results Patients were 89.76% male, 48.03% White, 87.93% non-Hispanic and the mean age was 60.51 (SD = 7.16) years. The proportion of robust, pre-frail and frail patients was 11.02% (n = 42), 59.58% (n = 227) and 29.40% (n = 112) respectively. The KAOP was completed by 381 and the IAT by 339 participants. In multinomial logistic regression, neither explicit ageist attitudes (KAOP scale score) nor implicit ageist attitudes (IAT) were associated with frailty in community dwelling Veterans after adjusting for covariates: OR = .98 (95% CI = .95–1.01), p = .221, and OR:=.97 (95% CI = .37–2.53), p = .950 respectively. Conclusions This study shows that neither explicit nor implicit ageist attitudes were associated with frailty in community dwelling Veterans. Further longitudinal and larger studies with more diverse samples and measured with other ageism scales should evaluate the independent contribution of ageist attitudes to frailty in older adults.

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NEIGHBORHOOD SOCIOECONOMIC STATUS AND GRAY MATTER VOLUME IN OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.1542 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S414-S414

Author(s):

Sara L Godina ◽

Caterina Rosano ◽

Peter J Gianaros ◽

Howard J Aizenstein ◽

Michelle C Carlson ◽

...

Keyword(s):

Older Adults ◽

Socioeconomic Status ◽

Cognitive Function ◽

Gray Matter ◽

Gray Matter Volume ◽

Community Dwelling ◽

Parahippocampal Gyrus ◽

Cross Sectional ◽

Neighborhood Socioeconomic Status ◽

Matter Volume

Abstract Lower neighborhood socioeconomic status (nSES) is associated with poorer cognitive function; underlying neural correlates are unknown. Cross-sectional associations of nSES (six census-derived measures of income, education, and occupation) and gray matter volume (GMV) of eight memory-related regions (hippocampus, middle frontal gyrus, amygdala, insula, parahippocampal gyrus, anterior, middle, and posterior cingulum) were examined in 264 community-dwelling older adults (mean age=83, 56.82% female, 39.02% black). In linear mixed effects models adjusted for total brain atrophy and accounting for geographic clustering, higher nSES was associated with greater GMV of the left hippocampus, left posterior cingulum, and bilateral insula, middle frontal, and parahippocampal gyri. nSES remained associated with GMV of the right insula (β= -32.26, p=0.026, 95%CI: -60.66, -3.86) after adjusting for individual level age, gender, race, income, and education. The nSES and cognitive function association may not be due to gray matter volume differences; other behavioral and biological mediators should be explored.

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Sarcopenia, physical frailty, undernutrition and obesity cooccurrence among Portuguese community-dwelling older adults: results from Nutrition UP 65 cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-033661 ◽

2020 ◽

Vol 10 (6) ◽

pp. e033661 ◽

Cited By ~ 2

Author(s):

Ana Rita Sousa-Santos ◽

Cláudia Afonso ◽

Nuno Borges ◽

Alejandro Santos ◽

Patrícia Padrão ◽

...

Keyword(s):

Older Adults ◽

Nutritional Assessment ◽

Multinomial Logistic Regression ◽

Short Form ◽

Mini Nutritional Assessment ◽

Community Dwelling ◽

Secondary Outcome ◽

Physical Frailty ◽

Cross Sectional ◽

European Working

ObjectivesTo investigate the coexistence of sarcopenia, frailty, undernutrition and obesity and to identify the factors associated with the cooccurrence of these conditions in an older population.DesignCross-sectional.SettingPortugal.Participants1454 older adults with 65 years or older, from Nutrition UP 65 study.Primary and secondary outcome measuresSarcopenia was identified using the European Working Group on Sarcopenia in Older People 2 guidelines and physical frailty using Fried phenotype. Mini-Nutritional Assessment-Short Form was used to ascertain undernutrition, and obesity was evaluated by body mass index.Results57.3% presented at least one condition, 38.0% were identified with one and 19.3% were identified with two or more conditions. When all preconditions were considered, 95.7% of the older adults presented at least one of these preconditions or conditions. Multinomial logistic regression multivariate analysis revealed that being male (OR 0.61; 95% CI 0.43 to 0.88), being married or in a common-law marriage (OR 0.58; 95% CI 0.40 to 0.84) and having a higher educational level (OR 0.23; 95% CI 0.07 to 0.73) were inversely associated with having two or more conditions, while age >75 years (OR 1.60; 95% CI 1.14 to 2.24), a poor self-perception of health status (OR 5.61; 95% CI 3.50 to 9.01), ≥5 medications (OR 3.11; 95% CI 1.77 to 5.46) and cognitive impairment (OR 1.84; 95% CI 1.37 to 2.48) were directly associated.ConclusionsAlmost three out of five older adults presented at least one of the conditions related to nutritional status, and about one in five had two or more of these occurrences. However, the low coexistence observed between all of these reinforces the need to assess them all individually during the geriatric assessment.

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The association between motor capacity and mobility performance: frailty as a moderator

European Review of Aging and Physical Activity ◽

10.1186/s11556-019-0223-4 ◽

2019 ◽

Vol 16 (1) ◽

Cited By ~ 4

Author(s):

Carl-Philipp Jansen ◽

Nima Toosizadeh ◽

M. Jane Mohler ◽

Bijan Najafi ◽

Christopher Wendel ◽

...

Keyword(s):

Older Adults ◽

Frailty Index ◽

Community Dwelling ◽

Daily Routine ◽

Cross Sectional ◽

Mobility Performance ◽

Frailty Status ◽

Walking Performance ◽

And Performance ◽

The Relationship

Abstract Background In older adults, the linkage between laboratory-assessed ‘motor capacity’ and ‘mobility performance’ during daily routine is controversial. Understanding factors moderating this relationship could help developing more valid assessment as well as intervention approaches. We investigated whether the association between capacity and performance becomes evident with transition into frailty, that is, whether frailty status moderates their association. Methods We conducted a cross-sectional analysis of the observational Arizona Frailty Cohort Study (ClinicalTrials.gov identifier: NCT01880229) in a community-dwelling cohort in Tucson, Arizona. Participants were N = 112 older adults aged 65 years or older who were categorized as non-frail (n = 40), pre-frail (n = 53) or frail (n = 19) based on the Fried frailty index. Motor capacity was quantified as normal (NWS) and fast walking speed (FWS). Mobility performance was quantified as 1) cumulated physical activity (PA) time and 2) everyday walking performance (average steps per walking bout; maximal number of steps in one walking bout), measured by a motion sensor over a 48 h period. Hierarchical linear regression analyses were performed to evaluate moderation effects. Results Unlike in non-frail persons, the relationship between motor capacity and mobility performance was evident in pre-frail and frail persons, confirming our hypothesis. A moderating effect of frailty status was found for 1) the relationship between both NWS and FWS and maximal number of steps in one bout and 2) NWS and the average steps per bout. No moderation was found for the association between NWS and FWS with cumulated PA. Conclusion In pre-frail and frail persons, motor capacity is associated with everyday walking performance, indicating that functional capacity seems to better represent mobility performance in this impaired population. The limited relationship found in non-frail persons suggests that other factors account for their mobility performance. Our findings may help to inform tailored assessment approaches and interventions taking into consideration a person’s frailty status.

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