Journal ArticleDOI
Operationalization of Frailty Using Eight Commonly Used Scales and Comparison of Their Ability to Predict All‐Cause Mortality
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TLDR
To operationalize frailty using eight scales and to compare their content validity, feasibility, prevalence estimates of frailty, and ability to predict all‐cause mortality, it is shown that the former are more reliable than the latter.Abstract:
Objectives: To operationalize frailty using eight scales and to compare their content validity, feasibility, prevalence estimates of frailty, and ability to predict all-cause mortality.
Design: Secondary analysis of the Survey of Health, Ageing and Retirement in Europe (SHARE).
Setting: Eleven European countries.
Participants: Individuals aged 50 to 104 (mean age 65.3 ± 10.5, 54.8% female, N = 27,527).
Measurements: Frailty was operationalized using SHARE data based on the Groningen Frailty Indicator, the Tilburg Frailty Indicator, a 70-item Frailty Index (FI), a 44-item FI based on a Comprehensive Geriatric Assessment (FI-CGA), the Clinical Frailty Scale, frailty phenotype (weighted and unweighted versions), the Edmonton Frail Scale, and the FRAIL scale.
Results: All scales had fewer than 6% of cases with at least one missing item, except the SHARE-frailty phenotype (11.1%) and the SHARE-Tilburg (12.2%). In the SHARE-Groningen, SHARE-Tilburg, SHARE-frailty phenotype, and SHARE-FRAIL scales, death rates were 3 to 5 times as high in excluded cases as in included ones. Frailty prevalence estimates ranged from 6% (SHARE-FRAIL) to 44% (SHARE-Groningen). All scales categorized 2.4% of participants as frail. Of unweighted scales, the SHARE-FI and SHARE-Edmonton scales most accurately predicted mortality at 2 (SHARE-FI area under the receiver operating characteristic curve (AUC) = 0.77, 95% confidence interval (CI) = 0.75�0.79); SHARE-Edmonton AUC = 0.76, 95% CI = 0.74�0.79) and 5 (both AUC = 0.75, 95% CI = 0.74�0.77) years. The continuous score of the weighted SHARE-frailty phenotype (AUC = 0.77, 95% CI = 0.75�0.78) predicted 5-year mortality better than the unweighted SHARE-frailty phenotype (AUC = 0.70, 95% CI = 0.68�0.71), but the categorical score of the weighted SHARE-frailty phenotype did not (AUC = 0.70, 95% CI = 0.68�0.72).
Conclusion: Substantive differences exist between scales in their content validity, feasibility, and ability to predict all-cause mortality. These frailty scales capture related but distinct groups. Weighting items in frailty scales can improve their predictive ability, but the trade-off between specificity, predictive power, and generalizability requires additional evaluation.read more
Citations
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Journal ArticleDOI
Frailty measurement in research and clinical practice: A review
TL;DR: How well these measurements operationalise frailty according to Clegg's guidelines for frailty classification is examined - that is: their accuracy in identifying frailty; their basis on biological causative theory; and their ability to reliably predict patient outcomes and response to potential therapies.
Journal ArticleDOI
Development and validation of a hospital frailty risk score focusing on older people in acute care settings using electronic hospital records; an observational study
Thomas Gilbert,Jenny Neuburger,Joshua Kraindler,Eilís Keeble,Paul V. Smith,Cono Ariti,Sandeepa Arora,Andrew Street,Stuart G Parker,Helen C. Roberts,Martin Bardsley,Simon Conroy +11 more
TL;DR: The Hospital Frailty Risk Score provides hospitals and health systems with a low-cost, systematic way to screen for frailty and identify a group of patients who are at greater risk of adverse outcomes and for whom a frailty-attuned approach might be useful.
Journal ArticleDOI
Frailty: An Emerging Public Health Priority
Matteo Cesari,Martin Prince,Jotheeswaran Amuthavalli Thiyagarajan,Islene Araujo de Carvalho,Roberto Bernabei,Piu Chan,Luis Miguel Gutiérrez-Robledo,Jean-Pierre Michel,John E. Morley,Paul Ong,Leocadio Rodríguez Mañas,Alan J. Sinclair,Chang Won Won,John R. Beard,Bruno Vellas +14 more
TL;DR: The identification of frailty as a target for implementing preventive interventions against age-related conditions is pivotal and every effort should be made by health care authorities to maximize efforts in this field.
Journal ArticleDOI
Sex differences in frailty: A systematic review and meta-analysis.
TL;DR: The pattern of sex differences in the FI and mortality of older adults was consistent across populations and confirmed a ‘male‐female health‐survival paradox’.
Journal ArticleDOI
Frailty and cancer: Implications for oncology surgery, medical oncology, and radiation oncology.
Cecilia G. Ethun,Mehmet Asim Bilen,Ashesh B. Jani,Shishir K. Maithel,Kenneth Ogan,Viraj A. Master +5 more
TL;DR: The concept of frailty has become increasingly recognized as one of the most important issues in health care and health outcomes and is of particular importance in patients with cancer who are receiving treatment with surgery, chemotherapy, and radiotherapy as discussed by the authors.
References
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Journal ArticleDOI
Frailty in Older Adults Evidence for a Phenotype
Linda P. Fried,Catherine M. Tangen,Jeremy D. Walston,Anne B. Newman,Calvin H. Hirsch,John S. Gottdiener,Teresa E. Seeman,Russell P. Tracy,Willem J. Kop,B Gregory Burke,Mary Ann McBurnie +10 more
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Journal Article
Cardiovascular Health Study Collaborative Research Group : Frailty in older adults : evidence for a phenotype
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A global clinical measure of fitness and frailty in elderly people
Kenneth Rockwood,Xiaowei Song,Chris MacKnight,Howard Bergman,David B. Hogan,Ian McDowell,Arnold Mitnitski +6 more
TL;DR: The ability of the Clinical Frailty Scale to predict death or need for institutional care, and correlated the results with those obtained from other established tools are determined.
Journal ArticleDOI
A standard procedure for creating a frailty index
Samuel D Searle,Arnold Mitnitski,Arnold Mitnitski,Evelyne A. Gahbauer,Thomas M. Gill,Kenneth Rockwood,Kenneth Rockwood +6 more
TL;DR: A systematic process for creating a frailty index, which relates deficit accumulation to the individual risk of death, showed reproducible properties in the Yale Precipitating Events Project cohort study.
Journal ArticleDOI
Prevalence of Frailty in Community-Dwelling Older Persons: A Systematic Review
TL;DR: To systematically compare and pool the prevalence of frailty, including prefrailty, reported in community‐dwelling older people overall and according to sex, age, and definition ofFrailty used.
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