Operationalization of a frailty index among older adults in the InCHIANTI study : predictive ability for all-cause and cardiovascular disease mortality
Hoogendijk, Emiel O. (Amsterdam UMC. University Medical Center)
Stenholm, Sari (University of Turku and Turku University Hospital. Centre for Population Health Research)
Ferrucci, Luigi (National Institute on Aging (Estats Units d'Amèrica))
Bandinelli, Stefania (Azienda Sanitaria di Firenze. Geriatric Unit)
Inzitari, Marco (Universitat Autònoma de Barcelona. Departament de Medicina)
Cesari, Matteo (University of Milan. Department of Clinical Sciences and Community Health)

Data:	2020
Resum:	The frailty index (FI) is a sensitive instrument to measure the degree of frailty in older adults, and is increasingly used in cohort studies on aging. To operationalize an FI among older adults in the "Invecchiare in Chianti" (InCHIANTI) study, and to validate its predictive capacity for mortality. Longitudinal data were used from 1129 InCHIANTI participants aged ≥ 65 years. A 42-item FI was operationalized following a standard procedure using baseline data (1998/2000). Associations of the FI with 3- and 6-year all-cause and cardiovascular disease (CVD) mortality were studied using Cox regression. Predictive accuracy was estimated by the area under the ROC curve (AUC), for a continuous FI score and for different cut-points. The median FI was 0. 13 (IQR 0. 08-0. 21). Scores were higher in women, and at advanced age. The FI was associated with 3- and 6-year all-cause and CVD mortality (HR range per 0. 01 FI increase = 1. 03-1. 07, all p < 0. 001). The continuous FI score predicted the mortality outcomes with moderate-to-good accuracy (AUC range 0. 72-0. 83). When applying FI cut-offs between 0. 15 and 0. 35, the accuracy of this FI for predicting mortality was moderate (AUC range 0. 61-0. 76). Overall, the predictive accuracy of the FI was higher in women than in men. The FI operationalized in the InCHIANTI study is a good instrument to grade the risk of all-cause mortality and CVD mortality. More measurement properties, such as the responsiveness of this FI when used as outcome measure, should be investigated in future research. The online version of this article (10. 1007/s40520-020-01478-3) contains supplementary material, which is available to authorized users.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Frail elderly ; Frailty index ; Deficit accumulation ; Risk prediction ; Geriatrics
Publicat a:	Aging Clinical and Experimental Research, Vol. 32 (january 2020) , p. 1025-1034, ISSN 1720-8319

DOI: 10.1007/s40520-020-01478-3
PMID: 32006385

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