Identification of Frailty Predictors of Adverse Health Outcomes in Community-dwelling Individuals Aged 50 and Over (SUCCEED)

Identification of Frailty Predictors of Adverse Health Outcomes in Community-dwelling Individuals Aged 50 and Over: the SUCCEED Prospective Cohort

Introduction. Although ageing is a general phenomenon, a great inter individual variability on the quality of ageing can be observed. This substantial heterogeneity may be partly explained by extrinsic factors such as lifestyle, habits, physical activity, diet, which may play an important role in the age-associated declines. The concept of frailty was introduced to account for variability in the aging process. This clinical and biological syndrome reflects a decrease in the physiological reserve, and leads to an insidious, precarious equilibrium that can break down during a stressful life event. In older adults, frailty is known to be associated with an increased risk of adverse outcomes, such as falls, fractures, unplanned hospitalizations, and death. Several frailty domains may only be slightly altered, so that early-stage frailty is not necessarily clinically visible. The most commonly used operational definitions of frailty are based on two different conceptual frameworks. Fried's rules-based criteria correspond to a physical phenotype, whereas the "Rockwood accumulative model" defines frailty as the accumulation of multiple deficits. These tools were built for individuals aged 65 and over. However, frailty can also be found in younger adults. Although the early detection of frailty is potentially important (since the condition might be reversible in its early stages), frailty has not been extensively investigated among middle-aged individuals. Indeed, most of the literature studies have focused on older adults or on a small number of frailty parameters the investigators hypothesized that the factors determining the main ageing-related adverse events are already present in middle age.

The main objectives of the SUCCEED cohort are therefore to 1/investigate the prevalence of frailty parameters in community-dwelling individuals aged 50 and over, 2/ assess the parameters' prognostic value for future adverse health events, 3/ investigate frailty classifications in this population and assess the evolution of profiles over time Method. The SUCCEED survey is a French retrospective and prospective cohort that includes community-dwelling individuals aged 50 years or over consecutively attending an outpatient clinic ("successful ageing") in a geriatric teaching hospital in the Paris area, France. Baseline parameters are collected using a self-administered questionnaire followed by an interview, physical measurements, and performance tests conducted by trained nurses, and then a standardized clinical evaluation by a geriatrician. This clinical assessment includes evaluation of autonomy, cognition, mood, balance, mobility, muscle strength, nutrition, comorbidities, continence, sensory functions, bone density, sleeping disorders.

Patients who have attended the outpatient clinic from the 01/01/2010 to 14/01/2020 are retrospectively included in the cohort, the other ones are prospectively included.

Study Overview

• Status: Not yet recruiting
• Conditions: Community Dwelling Individuals Aged 50 and Over

• Study Type: Observational
• Enrollment (Anticipated): 3000

Contacts and Locations

Study Locations

• France
  • Créteil, France, 94010
    • Assistance Publique Hôpitaux de Paris - CHU HENRI MONDOR
    • Contact: jean-philippe MD DAVID, PhD; Phone Number: +33149813012; Email: Jean-philipppe.david@aphp.fr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 50 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

community-dwelling individuals aged 50 years or over attending an outpatient clinic ("successful ageing") in a geriatric teaching hospital in the Paris area, France

Description

Inclusion Criteria:

• subjects aged 50 and over previously included in the SUCCEED survey as from 1/1/2010 and being followed up who do not refuse to allow their data to be used for research purposes
• subjects aged 50 and over coming for the first time to the successful ageing clinic who do not refuse to allow their data to be used for research purposes

Exclusion Criteria:

• Age below 50y
• Individuals who refuse to allow their data to be used for research purposes
• Legal guardianship
• Subjects not able to understand the study questionnaires, based on investigator's judgement
• Cognitive, mental or psychiatric condition that, based on investigator's judgement, would jeopardise study participation

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
number of morbid events	occurrence of 1 morbid event defined by the following composite criteria: death or institutionalization or pathological fracture (Pouteau-Colles type wrist, vertebral fracture or compression, femoral neck) or unscheduled hospitalization or non-accidental fall.	from baseline,during 40 years of follow up maximum

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Overall Survival	occurence of Death	from baseline , during 40 years of follow up maximum

Collaborators and Investigators

• Sponsor: Assistance Publique - Hôpitaux de Paris

Study record dates

Study Major Dates

• Study Start (Anticipated): December 1, 2020
• Primary Completion (Anticipated): September 30, 2035
• Study Completion (Anticipated): September 30, 2075

Study Registration Dates

• First Submitted: October 9, 2020
• First Submitted That Met QC Criteria: October 23, 2020
• First Posted (Actual): October 26, 2020

Study Record Updates

• Last Update Posted (Actual): October 26, 2020
• Last Update Submitted That Met QC Criteria: October 23, 2020
• Last Verified: September 1, 2020

More Information

Terms related to this study

• Keywords: frailty; prognosis; prevalence; ageing; community dwelling
• Additional Relevant MeSH Terms: Pathologic Processes; Frailty
• Other Study ID Numbers: APHP190906

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No