An alternative method for Frailty Index cut-off points to define frailty categories

作者：Romero Ortuno R^*

来源：European Geriatric Medicine, 2013, 4(5): 299-303.

DOI：10.1016/j.eurger.2013.06.005

• Frail elderly
• Severity of illness index
• Longitudinal study
• Mortality
• Validation studies

Purpose: The Frailty Index (FI) is a popular operationalization of frailty. FI cut-off points have been proposed to define, regardless of age, frailty categories with increasing risk. Here, an alternative method is described that takes age into account. %26lt;br%26gt;Subjects and methods: 29,905 participants aged 50 years or more from the first wave of the Survey of Health, Ageing and Retirement in Europe. The mean follow-up for mortality was 2.4 years. Curve estimation procedures were carried out between age and a FI, and 50% Confidence Intervals (CI) for the regression mean were derived. As opposed to the usual method (FI %26lt;= 0.08: non-frail; FI %26gt;= 0.25: frail; rest: pre-frail), the alternative method defines as %26apos;fit for their age%26apos; those with a FI below the lower 50% CI; %26apos;frail for their age%26apos; those with a FI above the upper 50% CI; the rest as %26apos;average for their age%26apos;. Using both methods, the prevalence of the frailty categories and their associated mortality rates were compared for each age group. %26lt;br%26gt;Results: The best fit between age and the FI was by cubic regression (R-2 = 0.174, P %26lt; 0.001). Among those in their 50s, 5% were frail by the usual method (mortality: 5%) and 14% by the alternative (mortality: 2%). Among those in their 90s, 64% were frail by the usual method (mortality: 43%) and 41% by the alternative (mortality: 48%). %26lt;br%26gt;Conclusion: The alternative method may be more sensitive in younger ages and more specific in older ages. This may have implications for population screening.

• 出版日期2013-11