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Number of Pregnancies and Trajectory of Frailty Index: English Longitudinal Study of Ageing

Kojima, G; Ogawa, K; Iliffe, S; Taniguchi, Y; Walters, K; (2020) Number of Pregnancies and Trajectory of Frailty Index: English Longitudinal Study of Ageing. Journal of the American Medical Directors Association , 21 (9) 1249-1253.e1. 10.1016/j.jamda.2020.04.010.

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Abstract

OBJECTIVES: Women are frailer than men across different populations and age groups. However, the mechanisms are still not fully understood. One possible cause is pregnancy and motherhood. The objective of this study was to examine trajectories of Frailty Index over time according to the number of pregnancies. DESIGN: A prospective study with repeated measures over 14 years. SETTING AND PARTICIPANTS: A total of 2060 community-dwelling older women aged ≥60 years in England. METHODS: The number of pregnancies was calculated as a sum of the number of live births and the number of miscarriages, still-births, or abortions. The Frailty Index (FI) was constructed using 60 deficits and repeatedly calculated every 2 years over 14 years. Trajectories of FI according to the number of pregnancies were estimated by a mixed effects model. RESULTS: Mean FI was 0.15 at baseline. A mixed effects model adjusted for age, smoking, alcohol use, education, and wealth showed that FI increased over time. A higher number of pregnancies were significantly associated with a higher FI (estimate = 0.0047, 95% confidence interval = 0.0020, 0.0074). CONCLUSIONS AND IMPLICATIONS: The current study showed that a higher number of pregnancies were significantly associated with a higher degree of frailty at baseline and over time. Pregnancy and child rearing may explain some of the observed excess risk of frailty in women. Pregnancy-related factors, such as pregnancy loss, types of delivery, length of pregnancy, childbearing, and child rearing, should be examined in relation to frailty in future studies.

Type: Article
Title: Number of Pregnancies and Trajectory of Frailty Index: English Longitudinal Study of Ageing
Location: United States
DOI: 10.1016/j.jamda.2020.04.010
Publisher version: https://doi.org/10.1016/j.jamda.2020.04.010
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Pregnancy, frail elderly, frailty, parity, trajectory
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10106508
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