# Assessment of Frailty Phenotype and Functional Limitations to Improve Prediction of Subsequent Health Care Utilization in Older Community-Dwelling Adults

> **NIH NIH R01** · UNIVERSITY OF MINNESOTA · 2021 · $484,763

## Abstract

Health care burden as manifested by greater health care utilization rises markedly with advancing age due in
part to increasing prevalence of multiple chronic medical conditions (multimorbidity). While multimorbidity is a
robust risk factor for higher health care burden, current multimorbidity measures explain only a modest
proportion of the variation in subsequent health care costs. In order to constrain health care burden without
negatively impacting health outcomes, improved understanding of key determinants of health care utilization
among older adults is essential. Risk factors from other domains (including potentially modifiable determinants)
would enhance identification of older community-dwelling adults likely to require costly care. Thus, models of
health care utilization including the potentially modifiable (but not routinely measured in clinical settings)
domains of the frailty phenotype and self-reported functional limitations may improve characterization of patient
risk profiles and therefore improve targeting and design of interventions to reduce subsequent health care
burden. The overarching objective of this proposal is to construct interpretable, generalizable and validated
models of health care costs and utilization among older community dwelling adults that identify clinical risk
factors amenable to targeted interventions to reduce risk of subsequent extensive and costly health care. We
will take advantage of the linkage between community-dwelling participants in four cohort studies of older
adults (Study of Osteoporotic Fractures [SOF]; Osteoporotic Fractures in Men Study [MrOS]; Health Aging and
Body Composition Study [Health ABC]; and National Health and Aging Trends Study [NHATS]) and their
Medicare claims data. We will perform a comprehensive evaluation of key potential clinical risk factors (frailty
phenotype, self-reported functional limitations and components of frailty phenotype and functional limitations)
for higher health care costs and utilization, after accounting for demographics and claims-based indicators of
multimorbidity and frailty. Our application is consistent with the NIA mission to conduct biological, clinical,
behavioral, social, and economic research related to the diseases and conditions associated with the aging
process. Our study combines a wide range of data from four large epidemiologic studies leveraging the value
of these cohorts in an efficient manner. If our hypotheses are confirmed, findings from our analyses will more
accurately characterize subsets of older community-dwelling adults at risk for intense, costly health care;
benefit health care systems/payers estimating costs vs. benefits of interventions aimed at delaying progression
to frailty and disability; support assessment of the frailty phenotype, functional status, or specific individual
components of these domains in the outpatient primary care practice setting; and direct the design of future
targeted intervention trials aimed at re...

## Key facts

- **NIH application ID:** 10242169
- **Project number:** 5R01AG067973-02
- **Recipient organization:** UNIVERSITY OF MINNESOTA
- **Principal Investigator:** KRISTINE ENSRUD
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $484,763
- **Award type:** 5
- **Project period:** 2020-09-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10242169

## Citation

> US National Institutes of Health, RePORTER application 10242169, Assessment of Frailty Phenotype and Functional Limitations to Improve Prediction of Subsequent Health Care Utilization in Older Community-Dwelling Adults (5R01AG067973-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10242169. Licensed CC0.

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