Research Paper Advance Articles
Frailty transitions in electronic health records: who first? what first?
- 1 Department of Epidemiology and Medical Quality Assessment, Meuhedet HMO, Tel-Aviv Yaffo 6203854, Israel
- 2 Director of Knowledge Development and Research, Joint-Eshel, 9 Eliezer Kaplan, Jerusalem 9103401, Israel
- 3 Director, Rehabilitation and Preservation of Functionality, Joint-Eshel, 9 Eliezer Kaplan, Jerusalem 9103401, Israel
- 4 Coordinator of Preservation of Functionality, Joint-Eshel, 9 Eliezer Kaplan, Jerusalem 9103401, Israel
- 5 Chief Geriatric Physician Meuhedet HMO, Tel-Aviv Yaffo 6203854, Israel
- 6 Director, Senior Citizen Department, Meuhedet HMO, Tel-Aviv Yaffo 6203854, Israel
- 7 Chief Geriatric Nurse, Meuhedet HMO, Tel-Aviv Yaffo 6203854, Israel
- 8 Data Analytics, Meuhedet HMO, Tel-Aviv Yaffo 6203854, Israel
- 9 MD, Medical Division, Meuhedet HMO, Tel-Aviv Yaffo 6203854, Israel
- 10 Research Institute, Meuhedet HMO, Tel-Aviv Yaffo 6203854, Israel
- 11 Chief Medical Officer, Meuhedet HMO, Tel-Aviv Yaffo 6203854, Israel
Received: October 14, 2024 Accepted: April 14, 2025 Published: May 12, 2025
https://doi.org/10.18632/aging.206247How to Cite
Copyright: © 2025 Hershkowitz Sikron et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: Frailty is associated with an increased risk of adverse health outcomes and may worsen over time.
Objectives: This study aims to describe the dynamic trajectory of frailty, identify the characteristics of those who deteriorate first, and determine what deteriorates first.
Study Design and Setting: A primary care longitudinal population-based cohort with repeated measures at baseline and one year later.
Participants: The cohort included all 119,952 Meuhedet members aged 65 years and over as of January 2023.
Predictors: Demographic factors, health indicators, and the Meuhedet Electronic Frailty Index containing 36 deficits.
Outcomes: Worsening frailty is defined as a higher frailty level one year later in 2024 compared to 2023. A new frailty deficit is defined as a deficit appearing in 2024 that was not present in 2023.
Statistical Analysis: The comparison of worsening percentages by demographic and clinical characteristics was tested using the chi-square test at the univariable level and logistic regression at the multivariable level.
Results: Overall, 13.3% of participants worsened after one year of follow-up, with 2.3% dying. Higher risk groups for worsening included females, older individuals, those belonging to the Arab sector, and those with multimorbidity. New deficits mainly included modifiable risk factors related to general health and functionality, despite chronic diseases being more frequent at baseline.
Conclusions: Emphasizing intervention programs based on these health promotion issues may significantly impact disease control and slow frailty worsening.
Abbreviations
HMO: Health Maintenance Organization; EFI: Electronic Frailty Index; MEFI: Meuhedet Electronic Frailty Index; EMR: Electronic Medical Record; SES: Socio-Economic Status; CCI: Charlson Comorbidity Index; BMI: Body Mass Index; aOR: adjusted Odd Ratio.