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Comparative Study
. 2009 Sep;57(9):1532-9.
doi: 10.1111/j.1532-5415.2009.02394.x. Epub 2009 Jul 21.

Validation and comparison of two frailty indexes: The MOBILIZE Boston Study

Dan K Kiely  1 , L Adrienne Cupples, Lewis A Lipsitz
Affiliations
Comparative Study

Validation and comparison of two frailty indexes: The MOBILIZE Boston Study

Dan K Kiely et al. J Am Geriatr Soc. 2009 Sep.

Abstract

Objectives: To validate two established frailty indexes and compare their ability to predict adverse outcomes in a diverse, elderly, community-dwelling sample of men and women.

Design: Prospective observational study.

Setting: A diverse defined geographic area of Boston.

Participants: Seven hundred sixty-five community-dwelling participants in the Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly Boston Study.

Measurements: Two published frailty indexes, recurrent falls, disability, overnight hospitalization, emergency department (ED) visits, chronic medical conditions, self-reported health, physical function, cognitive ability (including executive function), and depression. One index was developed from the Study of Osteoporotic Fractures (SOF) and the other from the Cardiovascular Health Study (CHS).

Results: The SOF frailty index classified 77.1% as robust, 18.7% as prefrail, and 4.2% as frail. The CHS frailty index classified 51.2% as robust, 38.8% as prefrail, and 10.0% as frail. Both frailty indexes (SOF; CHS) were similar in their ability to predict key geriatric outcomes such as recurrent falls (hazard ratio (HR)(frail)=2.2, 95% confidence interval (CI)=1.2-4.0; HR(frail)=1.9, 95% CI=1.2-3.1), overnight hospitalization (odds ratio (OR)(frail)=3.5, 95% CI=1.5-8.0; OR(frail)=4.4, 95% CI=2.4-8.2), ED visits (OR(frail)=3.5, 95% CI=1.4,8.8; OR(frail)=3.1, 95% CI=1.6-5.9), and disability (OR(frail)=5.4, 95% CI=2.3-12.3; OR(frail)=7.7, 95% CI=4.0-14.7), as well as chronic medical conditions, physical function, cognitive ability, and depression.

Conclusion: Two established frailty indexes were validated using an independent elderly sample of diverse men and women; both indexes were good at distinguishing geriatric conditions and predicting recurrent falls, overnight hospitalization, and ED visits according to level of frailty. Although both indexes are good measures of frailty, the simpler SOF index may be easier and more practical in a clinical setting.

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References

    1. Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004 Mar;59(3):255–263. - PubMed
    1. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146–156. - PubMed
    1. Bandeen-Roche K, Xue QL, Ferrucci L, et al. Phenotype of frailty: characterization in the women's health and aging studies. J Gerontol A Biol Sci Med Sci. 2006 Mar;61(3):262–266. - PubMed
    1. Boyd CM, Xue QL, Simpson CF, Guralnik JM, Fried LP. Frailty, hospitalization, and progression of disability in a cohort of disabled older women. Am J Med. 2005 Nov;118(11):1225–1231. - PubMed
    1. Cawthon PM, Marshall LM, Michael Y, et al. Frailty in older men: prevalence, progression, and relationship with mortality. J Am Geriatr Soc. 2007 Aug;55(8):1216–1223. - PubMed

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