# Promoting healthy aging among WTC responders: Frailty trajectories and intervention strategies

> **NIH ALLCDC U01** · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2024 · $599,563

## Abstract

Project Summary/Abstract
By 2030, the majority of World Trade Center (WTC) rescue and recovery workers (responders) will be aged 65
and over and at risk for aging-related conditions and consequences. Although the WTC General Responder
Cohort (WTC-GRC) is aging (median age is 59 in 2021), the WTC Health Program (WTCHP) does not
routinely collect data on aging-related syndromes. In particular, frailty is a common geriatric syndrome
characterized by increased vulnerability to adverse events including mortality, morbidity, disability and
hospitalizations. Recently, our multidisciplinary research team has developed a WTC-specific frailty
assessment tool (i.e., WTC Clinical Frailty Index/FI) based on clinically observable signs and symptoms of
aging regularly examined within WTCHP surveillance. Our preliminary data indicate that approximately 30% of
the WTC-GRC meets criteria for frailty as determined by WTC Clinical-FI, an association that increases with
age, WTC exposure, and by occupation type (e.g., higher risk among construction worker). These findings
underscore the urgent need for routine systematic assessments of structured aging-related indicators such as
frailty in the WTC-GRC. Moreover, we began pilot work to prospectively assess physical measures (e.g.,
Frailty Phenotype) and consequences of frailty (e.g., functional impairment, falls) in WTC general responders
who are followed at the Mount Sinai Clinical Center of Excellence (CCE) with an aim to improve the accuracy
of the WTC Clinical-FI. These efforts have provided the necessary first step to more accurately measure frailty
in WTC general responders. Thus, the overarching goals of this project are to further develop WTC Clinical-FI
to study frailty progression and associated risk factors and clinical outcomes, and begin piloting frailty
interventions in WTC general responders. Specially, we will determine frailty trajectories and risk factors
associated with these distinct trajectories using the repository of WTC-GRC health monitoring data already
collected at the Mount Sinai CCE (Aim 1); validate WTC Clinical-FI against Frailty Phenotype and determine its
predictive validity for aging-related clinical outcomes such as functional decline and falls in a longitudinal cohort
of general responders (Aim 2); and implement a pilot multicomponent intervention targeting modifiable risk
factors of frailty such as inappropriate medication use in a subset of general responders (Aim 3). Identifying
modifiable risk factors for frailty has the potential to impact the aging WTC responders of the entire WTCHP.
Results of this study will be instrumental in improving the capacity of WTCHP to monitor and care for aging
responders through partnership with Mount Sinai's nationally recognized Geriatrics and Palliative Care
programs including the development of future widespread multifactorial preventive programs tailored to WTC
responders to promote healthy aging.

## Key facts

- **NIH application ID:** 10848178
- **Project number:** 5U01OH012473-03
- **Recipient organization:** ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
- **Principal Investigator:** William W.,MPH, MD Hung
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2024
- **Award amount:** $599,563
- **Award type:** 5
- **Project period:** 2022-07-01 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10848178

## Citation

> US National Institutes of Health, RePORTER application 10848178, Promoting healthy aging among WTC responders: Frailty trajectories and intervention strategies (5U01OH012473-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10848178. Licensed CC0.

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