Static and dynamic measures of frailty predicted decline in performance-based and self-reported physical functioning.

ABSTRACT. Objective: To determine the effect of frailty on decline in physical functioning and to examine if chronic diseases modify this effect. Methods: The study sample was derived from the Longitudinal Aging Study Amsterdam and included respondents with initial ages 65 and over at T2 (1995/1996), who participated at T1 (1992/1993) and T2 and performed physical performance tests (n = 1,152) or reported functional limitations (n = 1,321) at T2 and T3 (1998/1999). Nine frailty markers were determined in two ways: low functioning at T2 (static definition); and decline in functioning between T1 and T2 (dynamic definition). Using logistic regression analyses, the effect of frailty was examined on change in physical functioning between T2 and T3, adjusting for sex, age, education, and additionally chronic diseases. Results: Static frailty was associated with performance decline only in the middle–old group (OR 2.43; 95%CI 1.23–4.80) and associated with decline in self-reported functioning (OR 2.44; 95%CI 1.77–3.36). Dynamic frailty was associated with decline in performance only in women (OR 1.72; 95%CI 1.11–2.67) and with self-reported functional decline (OR 1.77; 95%CI 1.29–2.43). These associations were independent of chronic diseases. Conclusion: Frailty is more strongly associated with self-reported functional decline in older persons than with performance decline.