Observational studyJournal of the American Geriatrics Society2021
Progression of Physical Frailty and the Risk of All-Cause Mortality: Is There a Point of No Return?
Observational study in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association of frailty and mortality risk in community-dwelling older adults: a systematic review and meta-analysis of 59 international prospective cohort studies.BMC public health · 2026Pooled it
- Impact of Exercise and Cognitive Stimulation Therapy on Physical Function, Cognition and Muscle Mass in Pre-Frail Older Adults in the Primary Care Setting: A Cluster Randomized Controlled Trial.The journal of nutrition, health & aging · 2023Trial
- Article
- Longitudinal Changes in Frailty and Major Adverse Cardiovascular Events in Patients With Coronary Heart Disease.Journal of the American Heart Association · 2026Article
- Associations of long-term average and variability of estimated glucose disposal rate with frailty progression: evidence from two prospective cohorts.Journal of translational medicine · 2026Article
- Association of Triglyceride-Glucose-Frailty Index with Cardiovascular Disease and All-Cause Mortality Incidence in Individuals with Cardiovascular-Kidney-Metabolic Syndrome Stages 0-3: A Nationwide Prospective Cohort Study.Journal of clinical medicine · 2026Article
- Prevalence and Outcomes of Frailty in Older Men-the Manitoba Follow-Up Study.Canadian geriatrics journal : CGJ · 2026Article
- Comparing the Relationship Between Social Determinants of Health and Frailty Status of Medicare Beneficiaries in Rural and Urban Areas in the United States.Journal of ageing and longevity · 2026Article
- Frailty and Cardiometabolic Outcomes: A Narrative Review.Journal of clinical medicine · 2026Review
- Association between cerebrospinal fluid volume and frailty in community-dwelling older adults: a cross-sectional study.Fluids and barriers of the CNS · 2026Article
- Association between triglyceride-glucose index and long-term frailty progression and transition in Chinese adults.Scientific reports · 2026Article
- The association of frailty with health care costs using the FRAIL scale.Aging clinical and experimental research · 2026Article
- HCT Frailty Scale (HCT-FS) for assessing frailty in adult candidates for allogeneic haematopoietic cell transplantation: an international prospective, observational cohort study.EClinicalMedicine · 2026Article
- Frailty of Health Care Systems.Canadian geriatrics journal : CGJ · 2025Article
- Physical Resilience After Hip Fracture: Unpacking the Roles of Resistance and Recovery.Journal of the American Geriatrics Society · 2025Article
- The Impact of Frailty, Activity of Daily Living, and Malnutrition on Mortality in Older Adults with Cognitive Impairment and Dementia.Nutrients · 2025Article
- Article
- Social isolation in relation to the incidence and dynamic progression of frailty in the oldest old: a trajectory analysis of a nationwide cohort.BMC public health · 2025Article
- Association of left atrial function with frailty: The Atherosclerosis Risk in Communities (ARIC) study.Journal of the American Geriatrics Society · 2024Article
- Sequential multiple mediating effect of loneliness and family health on physical frailty and willingness to age at home in older adults: a national survey in China.BMC geriatrics · 2024Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectivesTo investigate the rate and patterns of accumulation of frailty manifestations in relationship to all-cause mortality and whether there is a point in the progression of frailty beyond which the process becomes irreversible and death becomes imminent (a.k.a. point of no return).
designLongitudinal observational study.
settingCommunity or a non-nursing home residential care setting.
participantsTwo thousand five hundred and fifty seven robust older adults identified at baseline in 2011 with follow-up for all-cause mortality between 2011 and 2018. MEASUREMENTS: Frailty was measured by the physical frailty phenotype. Cox models were used to study the relationships of the number of frailty criteria (0-5) at each point in time and its accumulation patterns with all-cause mortality. Markov state-transition models were used to study annual transitions between health states (i.e., frailty, recovery, and death) after becoming frail among those with frailty onset (n = 373).
resultsThere was a nonlinear association between greater number of frailty criteria and increasing risk of mortality, with a notable risk acceleration after having accumulated all five criteria (hazard ratio (HR) = 32.6 vs none, 95% confidence interval (CI) = 15.7-67.5). In addition, the risk of one-year mortality tripled, and the likelihood of recovery (i.e., reverting to be robust or pre-frail) halved among those with five frailty criteria compared to those with three or four criteria. A 50% increase in mortality risk was also associated with frailty onset without (vs with) a prior history of pre-frailty (HR = 1.51, 95% CI = 1.20-1.90).
conclusionBoth the number and rate of accumulation of frailty criteria were associated with mortality risk. Although there was insufficient evidence to declare a point of no return, having all five-frailty criteria signals the beginning of a transition toward a point of no return. Ongoing monitoring of frailty progression could aid clinical and personal decision-making regarding timing of intervention and eventual transition from curative to palliative care.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.