A Frailty Index for UK Biobank Participants

Abstract

Background: Frailty indices (FIs) measure variation in health between aging individuals. Researching FIs in resources with large-scale genetic and phenotypic data will provide insights into the causes and consequences of frailty. Thus, we aimed to develop an FI using UK Biobank data, a cohort study of 500,000 middle-aged and older adults.

Methods: An FI was calculated using 49 self-reported questionnaire items on traits covering health, presence of diseases and disabilities, and mental well-being, according to standard protocol. We used multiple imputation to derive FI values for the entire eligible sample in the presence of missing item data (N = 500,336). To validate the measure, we assessed associations of the FI with age, sex, and risk of all-cause mortality (follow-up ≤ 9.7 years) using linear and Cox proportional hazards regression models.

Results: Mean FI in the cohort was 0.125 (SD = 0.075), and there was a curvilinear trend toward higher values in older participants. FI values were also marginally higher on average in women than in men. In survival models, 10% higher baseline frailty (ie, a 0.1 FI increment) was associated with higher risk of death (hazard ratio = 1.65; 95% confidence interval: 1.62-1.68). Associations were stronger in younger participants than in older participants, and in men than in women (hazard ratios: 1.72 vs. 1.56, respectively).

Conclusions: The FI is a valid measure of frailty in UK Biobank. The cohort's data are open access for researchers to use, and we provide script for deriving this tool to facilitate future studies on frailty.

Keywords: Biological aging; Frailty; Longevity; Mortality.

Figure 1.

Distribution of frailty index (FI) values by age at baseline (N = 500,336).

Figure 2.

Survival curves according to baseline age and frailty index (FI) categories, after ≤9.7 years of follow-up (N = 500,336). The age scale shows risk of mortality within the follow-up period according to the age at which individuals entered the cohort and their baseline FI category. For example, the average probability of survival after 9.7 years for a 70-year-old individual in the lowest FI category was approximately 90%.