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Articles by K. Rockwood
Total Records ( 2 ) for K. Rockwood
  R. E Hubbard , M. K Andrew and K. Rockwood

Introduction: parental age at conception may affect life expectancy. Adult daughters of older fathers seem to live shorter lives and, in one study, being born to a mother aged <25 was an important predictor of exceptional longevity. The effect of parental age on fitness/frailty in late life is unknown.

We aimed to investigate the relationships between parental age and frailty and longevity in older adults.

Methods: in the Canadian Study of Health and Aging (CSHA), data was collected on individuals aged ≥65 using a Self-Assessed Risk Factor Questionnaire and screening interview. In this secondary analysis, 5112 participants had complete data for parental age, frailty status and 10-year survival. Parental age was divided into three groups, with cut-offs at 25 and 45 for fathers and at 25 and 40 for mothers. Frailty was defined by an index of deficits. Survival was analysed using Kaplan-Meier curves and Cox regression with analyses adjusted for subject's age, sex and age of the other parent.

Results: mean maternal age at subject's birth was 29.2y (SD 6.8) and mean paternal age 33.3y (SD 7.8). There was no effect of maternal or paternal age on survival for either sons or daughters. Similarly, there was no association between parental age and subject frailty in old age.

Conclusion: we did not identify an association between parental age and frailty or longevity in older adult participants in the CSHA.

  R. E. Hubbard , M. K. Andrew , N. Fallah and K. Rockwood
  Aims  To compare the relative prognostic importance in older people of diagnosed diabetes, the number and severity of co-morbidities and frailty.

Methods  Two thousand three hundred and five people aged ≥ 70 years comprised the clinical examination cohort of the Canadian Study of Health and Aging. Frailty was defined as a score of ≥ 5 on a 7-point Clinical Frailty Scale. The cohort was followed for 5 years.

Results  Diabetes was more likely to be associated with medium-term mortality (adjusted hazard ratio (HR) 1.42; 95% confidence interval (CI) 1.20-1.69) than co-morbidity (HR 1.03; 95% CI 1.01-1.05). Frailty most strongly predicted death (HR 2.72; 95% CI 2.34-3.16). Frail older adults were 2.62 times (95% CI 1.36-5.06) more likely to have a complication of diabetes, independent of age, sex and number of years living with diabetes. People with diabetes were younger than those without (81.3 vs. 83.3 years) but a similar proportion were frail (42.2 vs.43.4%). The median life expectancy for frail older adults with diabetes was 23 months (95% CI 18-28 months).

Conclusions  In this cohort, the risk of mortality in older people was defined more precisely by a clinical measure of frailty than by diabetes or burden of co-morbidity. Those with diagnosed diabetes were younger than those without but had the same frailty status; diabetes can therefore be considered to increase ‘biological age’ by 2 years in those aged over 70 years. The limited life expectancy of frail older people with diabetes highlights the importance of recognizing frailty and supports the individualization of care in older people with diabetes.

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