Prognostic impact of main frailty domain trajectories on 5-year mortality in very old adults: results from the PARTAGE cohort study.
Fiche publication
Date publication
mars 2018
Journal
American journal of epidemiology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr GUILLEMIN Francis
Tous les auteurs :
Agrinier N, Erpelding ML, Labat C, Gautier S, Guillemin F, Benetos A
Lien Pubmed
Résumé
The objectives were to identify trajectories of nutrition, cognitive function and autonomy over time in very old adults and to assess their impact on mortality. A cohort, including subjects aged≥80 years in 2007-2008, who were followed for 5 years, in 72 Italian and French nursing homes, was used for post-hoc analyses. Body mass index (BMI), Mini Mental State Examination (MMSE), and index of activities of daily living (ADL) were assessed at 4 time points. Vital status was collected during the follow-up. Latent trajectory and Cox models were used. In the 710 subjects included, the mean(SD) age at inclusion was 88.0(0.8) years, and 78.9% were female. Seven composite trajectories were identified based on BMI, MMSE, and ADL values. As compared to the reference group (T7-stable overweight, preserved cognitive function and autonomy), two trajectories presented increased relative risk of dying: T1, stable overweight, moderately impaired then declining cognitive function and autonomy (adjusted HR = 1.79, 95%CI: 1.26,2.55), and T6, stable normal BMI, slight cognitive decline, and moderate then degrading loss of autonomy (adjusted HR = 1.67, 95%CI: 1.15,2.44). C-index was 0.81, 95%CI: 0.72,0.88. A repeated monitoring of BMI, MMSE, and ADL in very old adults provides trajectories with higher prognostic information than simple baseline assessment.
Référence
Am. J. Epidemiol.. 2018 Mar 15;: