Association of Frailty With Risk of Osteoarthritis Development, Progression, and Worse Clinical Outcomes in Older Adults
Bibliographic record
Abstract
Objective Both frailty and osteoarthritis (OA) become common with aging. Given their shared age-related incidence, we hypothesized that greater baseline frailty—measured by a frailty index—would be associated with worse OA outcomes, including higher incidence, poorer Knee Injury and Osteoarthritis Outcome Score (KOOS) trajectories, increased fall risk, and higher rates of total or partial knee arthroplasty (KA) or hip arthroplasty (HA) in middle-aged and older adults. Methods A frailty index score was calculated for 4753 participants (58.53% female; mean age 61.2 years, 95% CI 60.94-61.46) from the Osteoarthritis Initiative (OAI), broken into control, incidence, and progression groups. Longitudinal OAI outcomes including incidence, KOOS progression, falls, and KA/HA were extracted for ~9 years from baseline. Results Higher baseline frailty was associated with development of OA by 3-, 5-, and 9-year follow-up (all P < 0.001), with the greatest effect at 9 years (odds ratio [OR] 1.73, 95% CI 1.52-1.97, P < 0.001). Disease trajectory, as measured by KOOS subscale scores, was negatively influenced by increasing frailty (all P < 0.001), the greatest effect being on KOOS Function (estimate −9.52, 95% CI −10.28 to −8.77, P < 0.001). A 0.1 difference in baseline frailty index scores was associated with an increase in the odds of experiencing a fall within 3 years of baseline (OR 1.44, 95% CI 1.32-1.58, P < 0.001). Regardless of surgical site, frailty index scores did not significantly affect risk of experiencing KA/HA except in female participants undergoing HA (hazard ratio 1.29, 95% CI 1.04-1.61, P = 0.02). Conclusion Frailty was associated with greater risk of OA incidence and falls, as well as KOOS-measured disease progression, but not joint replacement surgery-free time.
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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 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 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) | 0.002 | 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".