The Risk Factors of Performance-Based Early Frailty in Midlife and Older Age.

Background: Identifying impairments prior to onset of physical frailty may inform targeted interventions. An objective, clinically feasible early frailty measure, termed performance-based early frailty (PBEF) was developed, and antecedent and current risk factors were examined. Method: Data were from N = 104 participants of the Fels Longitudinal Study. PBEF was derived from age-specific cut points for time to complete five chair stands and walk four meters. "Pre-PBEF" and "PBEF" were defined as impairment in one or both measures, respectively. Candidate PBEF risk factors included body composition, health and quality of life, grip strength, and biomarker measures. Results: Pre-PBEF was identified in 26% and 30% of midlife and older adults, and PBEF was identified in 11% and 14% of midlife and older adults, respectively. When predicting midlife PBEF, only current physical activity was significant (odds ratio [OR] = 0.18). In older adults, PBEF status was predicted by previous heavier drinking (OR = 3.09), previous better grip strength (OR = 0.92), current poorer sleep habits (OR = 1.19), and current higher C-reactive protein concentrations (OR = 1.20). Conclusion: Differing age group patterns of predictors emerged, suggesting that PBEF in midlife is likely a state influenced by current health status, whereas older age PBEF is influenced by both current and antecedent factors.