Comparison of the prognostic importance of diagnosed diabetes, co‐morbidity and frailty in older people
Bibliographic record
Abstract
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 > or = 70 years comprised the clinical examination cohort of the Canadian Study of Health and Aging. Frailty was defined as a score of > or = 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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".