Physical frailty and self-rated health, while related, capture distinct aspects of health, each independently and jointly predicting all-cause mortality, with SRH retaining prognostic value even among frail individuals.
Key Findings
Results
Frailty and pre-frailty were independently associated with increased hazard of all-cause mortality after adjusting for self-rated health.
Pre-frailty was associated with a 1.4-fold increased hazard of mortality compared to non-frail participants (p < .001)
Frailty was associated with a 2.0-fold increased hazard of mortality compared to non-frail participants (p < .001)
These associations were independent of self-rated health, demographic characteristics, and comorbidities
Sensitivity analyses excluding participants with probable or possible dementia at baseline yielded similar results
Results
Self-rated health was independently associated with all-cause mortality after adjusting for physical frailty status.
Reporting good SRH was associated with 29% higher hazard of mortality compared to excellent/very good SRH after adjusting for frailty (p < .001)
Reporting fair/poor SRH was associated with 59% higher hazard of mortality compared to excellent/very good SRH after adjusting for frailty (p < .001)
These associations were independent of frailty status, demographic characteristics, and comorbidities
Results
Fair/poor self-rated health was associated with higher mortality specifically among frail older adults, indicating SRH retains prognostic value within the frail subgroup.
The joint analysis showed fair/poor SRH was associated with higher mortality among the frail
This finding suggests SRH captures health dimensions not fully captured by physical frailty assessment alone
Sensitivity analyses excluding participants with dementia yielded similar results
Results
Although frailty and poor self-rated health were positively correlated, a substantial proportion of participants showed discordance between the two measures.
14% of the 7425 baseline participants were physically frail
25% of participants reported fair/poor SRH
12% of frail participants reported excellent/very good health
6.6% of those with fair/poor SRH were non-frail
These discordant cases suggest frailty and SRH capture distinct aspects of health status
Results
The study sample experienced substantial all-cause mortality over the follow-up period.
The study leveraged the National Health and Aging Trends Study of US Medicare beneficiaries followed annually from 2011 to 2019
Baseline sample consisted of 7425 participants
Median follow-up was 4.3 years
29% of participants died over the follow-up period
Sekhon V, Wani R, Wu C, Chu N, Xue Q. (2026). Physical frailty, self-rated health, and all-cause mortality: implications for understanding resilience in aging.. The journals of gerontology. Series A, Biological sciences and medical sciences. https://doi.org/10.1093/gerona/glag067