Background: The global number of centenarians is still strongly growing and information about the health and healthcare needs of this segment of the population is needed. This study aimed to estimate the prevalence of frailty among centenarians included in a multinational study and to investigate associated factors. Methods: The 5-COOP study is a cross-sectional survey including 1,253 centenarians in 5 countries (Japan, France, Switzerland, Denmark, and Sweden). Data were collected using a standardized questionnaire during a face-to-face interview (73.3%), telephone interview (14.5%), or by postal questionnaire (12.2%). The 5 dimensions of the frailty phenotype (weight loss, fatigue, weakness, slow walking speed, and low level of physical activity) were assessed by using self-reported data. Factors associated with frailty criteria were investigated by using multivariate regression models. Results: Almost 95% of the participants had at least 1 frailty criterion. The overall prevalence of frailty (3 criteria or more) was 64.7% (from 51.5% in Sweden to 77.6% in Switzerland), and 32.2% of the participants had 4 or 5 criteria. The most frequent criteria were weakness (84.2%), slow walking speed (77.6%), and low level of physical activity (72.5%), followed by fatigue (43.8%) and weight loss (23.8%). Factors associated with frailty included data collection modes, country of residence, gender, living in institution, depression, dementia, disability, falls, and sensory impairments. Conclusions: This study shows that reaching 100 years of age rarely goes without frailty and sheds light on factors associated with frailty at a very old age.

Keywords:
Frail elderly, Functional decline, International comparison, Longevity, Oldest old
1.
United Nations, Department of Economic and Social Affairs, Population Division: World Population Prospects: The 2015 Revision, Key Findings and Advance Tables. Working Paper No. ESA/P/WP.241. Available from: https://www.compassion.com/multimedia/world-population-prospects.pdf (accessed April 4, 2017).
2.
Robine JM, Cubaynes S: Worldwide demography of centenarians. Mech Ageing Dev 2017; 165: 59–67.
3.
Robine JM, Cambois E: Healthy life expectancy in Europe 2013. Available from: www.ined.fr/en/resources_documentation/publications/pop_soc/ (accessed April 4, 2017).
4.
Robine JM, Cambois E, Nusselder W, Jeune B, Oyen HV, Jagger C; JA: EHLEIS team: The joint action on healthy life years (JA: EHLEIS). Arch Public Health 2013; 71: 72.
5.
Rowe JW, Kahn RL: Human aging: usual and successful. Science 1987; 237: 143–149.
6.
Gill TM, Gahbauer EA, Han L, Allore HG: Trajectories of disability in the last year of life. N Engl J Med 2010; 362: 1173–1180.
7.
Christensen K, Thinggaard M, Oksuzyan A, Steenstrup T, Andersen-Ranberg K, Jeune B, McGue M, Vaupel JW: Physical and cognitive functioning of people older than 90 years: a comparison of two Danish cohorts born 10 years apart. Lancet 2013; 382: 1507–1513.
8.
Rasmussen SH, Thinggaard M, Hojgaard MB, Jeune B, Christensen K, Andersen-Ranberg K: Improvement in activities of daily living among Danish centenarians? J Gerontol A Biol Sci Med Sci 2017, Epub ahead of print.
9.
Herr M, Arvieu JJ, Robine JM, Ankri J: Health, frailty and disability after ninety: results of an observational study in France. Arch Gerontol Geriatr 2016; 66: 166–175.
10.
Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, Mitnitski A: A global clinical measure of fitness and frailty in elderly people. CMAJ 2005; 173: 489–495.
11.
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA: Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001; 56:M146–M156.
12.
Sirven N, Rapp T: The cost of frailty in France. Eur J Health Econ 2017; 18: 243–253.
13.
Sirven N, Rapp T: The dynamics of hospital use among older people evidence for Europe using SHARE data. Health Serv Res 2017; 52: 1168–1184.
14.
Bergman H, Ferrucci L, Guralnik J, Hogan DB, Hummel S, Karunananthan S, Wolfson C: Frailty: an emerging research and clinical paradigm – issues and controversies. J Gerontol A Biol Sci Med Sci 2007; 62: 731–737.
15.
Shamliyan T, Talley KM, Ramakrishnan R, Kane RL: Association of frailty with survival: a systematic literature review. Ageing Res Rev 2013; 12: 719–736.
16.
Herrmann FR, Osiek A, Cos M, Michel JP, Robine JM: Frailty judgment by hospital team members: degree of agreement and survival prediction. J Am Geriatr Soc 2005; 53: 916–917.
17.
Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, Cesari M, Chumlea WC, Doehner W, Evans J, Fried LP, Guralnik JM, Katz PR, Malmstrom TK, McCarter RJ, Gutierrez Robledo LM, Rockwood K, von Haehling S, Vandewoude MF, Walston J: Frailty consensus: a call to action. J Am Med Dir Assoc 2013; 14: 392–397.
18.
Puts MT, Toubasi S, Andrew MK, Ashe MC, Ploeg J, Atkinson E, Ayala AP, Roy A, Rodriguez Monforte M, Bergman H, McGilton K: Interventions to prevent or reduce the level of frailty in community-dwelling older adults: a scoping review of the literature and international policies. Age Ageing 2017; 46: 383–392.
19.
Dartigues JF: Methodological problems in clinical and epidemiological research on ageing (in French). Rev Epidemiol Sante Publique 2005; 53: 243–249.
20.
Collard RM, Boter H, Schoevers RA, Oude Voshaar RC: Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc 2012; 60: 1487–1492.
21.
Gu D, Feng Q: Frailty still matters to health and survival in centenarians: the case of China. BMC Geriatr 2015; 15: 159.
22.
Kwan JS, Lau BH, Cheung KS: Toward a comprehensive model of frailty: an emerging concept from the Hong Kong Centenarian Study. J Am Med Dir Assoc 2015; 16: 536 e1–e7.
23.
Ferrer A, Badia T, Formiga F, Sanz H, Megido MJ, Pujol R: Frailty in the oldest old: prevalence and associated factors. J Am Geriatr Soc 2013; 61: 294–296.
24.
Kojima G, Iliffe S, Taniguchi Y, Shimada H, Rakugi H, Walters K: Prevalence of frailty in Japan: a systematic review and meta-analysis. J Epidemiol 2017; 27: 347–353.
25.
Duarte N, Teixeira L, Ribeiro O, Paul C: Frailty phenotype criteria in centenarians: findings from the Oporto Centenarian Study. Eur Geriatr Med 2014; 5: 371–376.
26.
Robine JM, Cheung SL, Saito Y, Jeune B, Parker MG, Herrmann FR: Centenarians today: new insights on selection from the 5-COOP study. Curr Gerontol Geriatr Res 2010; 2010: 120354.
27.
Kontis V, Bennett JE, Mathers CD, Li G, Foreman K, Ezzati M: Future life expectancy in 35 industrialised countries: projections with a Bayesian model ensemble. Lancet 2017; 389: 1323–1335.
28.
Herr M, Robine JM, Pinot J, Arvieu JJ, Ankri J: Polypharmacy and frailty: prevalence, relationship, and impact on mortality in a French sample of 2350 old people. Pharmacoepidemiol Drug Saf 2015; 24: 637–646.
29.
Santos-Eggimann B, Cuenoud P, Spagnoli J, Junod J: Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries. J Gerontol A Biol Sci Med Sci 2009; 64: 675–681.
30.
Herr M, Robine JM, Aegerter P, Arvieu JJ, Ankri J: Contribution of socioeconomic position over life to frailty differences in old age: comparison of life-course models in a French sample of 2350 old people. Ann Epidemiol 2015; 25: 674–680 e1.
31.
Linard M, Herr M, Aegerter P, Czernichow S, Goldberg M, Zins M, Ankri J: Should sensory impairment be considered in frailty assessment? A study in the GAZEL cohort. J Nutr Health Ageing 2016; 20: 714–721.
32.
Vestergaard S, Andersen-Ranberg K, Skytthe A, Christensen K, Robine JM, Jeune B: Health and function assessments in two adjacent Danish birth cohorts of centenarians: impact of design and methodology. Eur J Ageing 2016; 13: 15–23.
33.
Sutton JL, Gould RL, Daley S, Coulson MC, Ward EV, Butler AM, Nunn SP, Howard RJ: Psychometric properties of multicomponent tools designed to assess frailty in older adults: a systematic review. BMC Geriatr 2016; 16: 55.
© 2018 S. Karger AG, Basel
2018
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.