Guowei Li, Alexandra Papaioannou, Lehana Thabane, Ji Cheng, Jonathan D Adachi

Investigating the cumulative rate of deficits and the change of a frailty index (FI) chronologically is helpful in clinical and research settings in the elderly. However, limited evidence for the change of frailty before and after some nonfatal adverse health event such as a major osteoporotic fracture (MOF) is available. Data from the Global Longitudinal Study of Osteoporosis in Women 3-year Hamilton cohort were used in this study. The changes of FI before and after onset of MOF were compared between the women with and without incident MOF. We also evaluated the relationship between risk of MOF, falls and death and the change of FI and the absolute FI measures. There were 3,985 women included in this study (mean age: 69.4 years). The change of FI was significantly larger in the women with MOF than those without MOF at Year 1 (0.085 vs. 0.067, p-value = 0.036) and Year 2 (0.080 vs. 0.052, p-value = 0.042) post-baseline. The FI change was not significantly related with risk of MOF independently of age. However the absolute FI measures were significantly associated with increased risk of MOF, falls and death independently of age. In summary, the increase of the FI is significantly larger in the elderly women experiencing a MOF than their peer controls, indicating their worsening frailty and greater deficit accumulation after a MOF. Measures of the FI change may aid in the understanding of cumulative aging nature in the elderly and serve as an instrument for intervention planning and assessment. This article is protected by copyright. All rights reserved.