To test whether women age ≥ 55 years with increasing evidence of a frailty phenotype would have greater risk of fractures, disability, and recurrent falls, compared with women who were not frail, across geographic areas (Australia, Europe, and North America) and age groups.
Multinational, longitudinal, observational cohort study.
The Global Longitudinal Study of Osteoporosis in Women (GLOW).
Women (n=48,636) age ≥ 55 years enrolled at sites in Australia, Europe, and North America.
Components of frailty (slowness/weakness, poor endurance/exhaustion, physical activity, and unintentional weight loss) at baseline and report of fracture, disability, and recurrent falls at 1 year of follow-up were investigated. Women also reported health and demographic characteristics at baseline.
Among those age < 75 years, women from the United States were more likely to be prefrail and frail than women from Australia/Canada, and Europe. The distribution of frailty was similar by region for women age ≥ 75 years. Odds ratios from multivariable models for frailty versus non frailty were 1.23 (95% CI = 1.07–1.42) for fracture, 2.29 (95% CI = 2.09–2.51) for disability, and 1.68 (95% CI = 1.54–1.83) for recurrent falls. The associations for pre-frailty versus non frailty were weaker but still indicated statistically significant increased risk for each outcome. Overall, associations between frailty status and each outcome were similar across age and geographic region.
Increased evidence of a frailty phenotype is associated with increased risk for fracture, disability, and falls among women age ≥ 55 years in 10 countries, with similar patterns across age and geographic region.