Frailty tied to higher risk of OA incidence, falls

Frailty appears predictive of an increased risk of osteoarthritis (OA) incidence and falls, as well as disease progression, in older adults, a study has shown. However, no association exists between frailty and joint replacement surgery-free time.

A total of 4,753 participants (mean age 61.2 years, 58.53 percent female) from the Osteoarthritis Initiative (OAI) had their frailty index score calculated. The investigators then extracted longitudinal OAI outcomes including incidence, Knee Injury and Osteoarthritis Outcome Score (KOOS) progression, falls, and knee/hip arthroplasty (KA/HA) for approximately 9 years from baseline.

Higher frailty at baseline significantly correlated with OA development by 3-, 5-, and 9-year follow-up (p<0.001 for all), with the greatest effect seen at year 9 (odds ratio [OR], 1.73, 95 percent confidence interval [CI], 1.52‒1.97; p<0.001).

Increasing frailty had a negative impact on disease trajectory, as measured by KOOS subscale scores, with the greatest impact being on KOOS Function (estimate, ‒9.52, 95 percent confidence interval [CI], ‒10.28 to ‒8.77; p<0.001). Moreover, a 0.1 difference in baseline frailty index scores correlated with a higher likelihood of having a fall within 3 years of baseline (OR, 1.44, 95 percent CI, 1.32‒1.58; p<0.001).

“Regardless of surgical site, frailty index scores did not significantly affect risk of experiencing KA/HA except in female participants undergoing HA (hazard ratio, 1.29, 95 percent CI, 1.04‒1.61; p=0.02),” the investigators said.