A1 Refereed original research article in a scientific journal
Operationalization of a frailty index among older adults in the InCHIANTI study: predictive ability for all-cause and cardiovascular disease mortality
Authors: Emiel O. Hoogendijk, Sari Stenholm, Luigi Ferrucci, Stefania Bandinelli, Marco Inzitari, Matteo Cesari
Publisher: SPRINGER
Publication year: 2020
Journal: Aging Clinical and Experimental Research
Journal name in source: AGING CLINICAL AND EXPERIMENTAL RESEARCH
Journal acronym: AGING CLIN EXP RES
Volume: 32
Issue: 6
First page : 1025
Last page: 1034
Number of pages: 10
ISSN: 1594-0667
eISSN: 1720-8319
DOI: https://doi.org/10.1007/s40520-020-01478-3
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/46367954
Background 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. Aims To operationalize an FI among older adults in the "Invecchiare in Chianti" (InCHIANTI) study, and to validate its predictive capacity for mortality. Methods 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. Results 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. Conclusions 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.
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