Clinical and functional predictors of mortality in octogenarians: limitations of the Fried frailty phenotype for risk stratification

Abstract

Abstract Objective To evaluate frailty as a predictor of mortality in octogenarians. Methods This retrospective cohort study included individuals aged 80 years or older who were followed from 2016–2018 through 2024–2025. Sociodemographic, clinical, and functional variables, including the presence of frailty, were analyzed, with all-cause mortality as the outcome. Data analysis included descriptive statistics and multivariable Cox regression to estimate the factors associated with mortality. Results Osteoporosis, urinary incontinence, and severe depressive symptoms were identified as predictors of mortality. The Fried frailty phenotype did not demonstrate significant predictive value for mortality in the sample analyzed. Conclusion Frailty, when assessed on the basis of specific clinical and functional conditions, was relevant for predicting mortality among the oldest-old, whereas the Fried frailty phenotype showed limitations in this age group. These findings reinforce the need for more sensitive instruments for prognostic assessment in individuals aged 80 years or older.