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The ability of three different models of frailty to predict all-cause mortality: Results from the European Male Aging Study (EMAS)

Ravindrarajah, Rathi; Lee, David M.; Pye, Stephen R.; Gielen, Evelien; Boonen, Steven; Vanderschueren, Dirk; Pendleton, Neil; Finn, Joseph D.; Tajar, Abdelouahid and O'Connell, Matthew D. L., et al. (2013) In Archives of Gerontology and Geriatrics 57(3). p.360-368
Abstract
Few studies have directly compared the ability of the most commonly used models of frailty to predict mortality among community-dwelling individuals. Here, we used a frailty index (FI), frailty phenotype (FP), and FRAIL scale (FS) to predict mortality in the EMAS. Participants were aged 40-79 years (n = 2929) at baseline and 6.6% (n = 193) died over a median 4.3 years of follow-up. The FI was generated from 39 deficits, including self-reported health, morbidities, functional performance and psychological assessments. The FP and FS consisted of five phenotypic criteria and both categorized individuals as robust when they had 0 criteria, prefrail as 1-2 criteria and frail as 3+ criteria. The mean FI increased linearly with age (r(2) = 0.21)... (More)
Few studies have directly compared the ability of the most commonly used models of frailty to predict mortality among community-dwelling individuals. Here, we used a frailty index (FI), frailty phenotype (FP), and FRAIL scale (FS) to predict mortality in the EMAS. Participants were aged 40-79 years (n = 2929) at baseline and 6.6% (n = 193) died over a median 4.3 years of follow-up. The FI was generated from 39 deficits, including self-reported health, morbidities, functional performance and psychological assessments. The FP and FS consisted of five phenotypic criteria and both categorized individuals as robust when they had 0 criteria, prefrail as 1-2 criteria and frail as 3+ criteria. The mean FI increased linearly with age (r(2) = 0.21) and in Cox regression models adjusted for age, center, smoking and partner status the hazard ratio (HR) for death for each unit increase of the FI was 1.49. Men who were prefrail or frail by either the FP or FS definitions, had a significantly increased risk of death compared to their robust counterparts. Compared to robust men, those who were FP frail at baseline had a HR for death of 3.84, while those who were FS frail had a HR of 3.87. All three frailty models significantly predicted future mortality among community-dwelling, middle-aged and older European men after adjusting for potential confounders. Our data suggest that the choice of frailty model may not be of paramount importance when predicting future risk of death, enabling flexibility in the approach used. (C) 2013 Elsevier Ireland Ltd. All rights reserved. (Less)
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keywords
Frailty index, Frailty phenotype, Mortality, Population-based, Male, health, Aging
in
Archives of Gerontology and Geriatrics
volume
57
issue
3
pages
360 - 368
publisher
Elsevier
external identifiers
  • wos:000324024300019
  • scopus:84881668496
ISSN
1872-6976
DOI
10.1016/j.archger.2013.06.010
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English
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bff75e5f-496b-433e-88d3-444ab05b68b3 (old id 4106283)
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2013-11-07 14:20:13
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@article{bff75e5f-496b-433e-88d3-444ab05b68b3,
  abstract     = {Few studies have directly compared the ability of the most commonly used models of frailty to predict mortality among community-dwelling individuals. Here, we used a frailty index (FI), frailty phenotype (FP), and FRAIL scale (FS) to predict mortality in the EMAS. Participants were aged 40-79 years (n = 2929) at baseline and 6.6% (n = 193) died over a median 4.3 years of follow-up. The FI was generated from 39 deficits, including self-reported health, morbidities, functional performance and psychological assessments. The FP and FS consisted of five phenotypic criteria and both categorized individuals as robust when they had 0 criteria, prefrail as 1-2 criteria and frail as 3+ criteria. The mean FI increased linearly with age (r(2) = 0.21) and in Cox regression models adjusted for age, center, smoking and partner status the hazard ratio (HR) for death for each unit increase of the FI was 1.49. Men who were prefrail or frail by either the FP or FS definitions, had a significantly increased risk of death compared to their robust counterparts. Compared to robust men, those who were FP frail at baseline had a HR for death of 3.84, while those who were FS frail had a HR of 3.87. All three frailty models significantly predicted future mortality among community-dwelling, middle-aged and older European men after adjusting for potential confounders. Our data suggest that the choice of frailty model may not be of paramount importance when predicting future risk of death, enabling flexibility in the approach used. (C) 2013 Elsevier Ireland Ltd. All rights reserved.},
  author       = {Ravindrarajah, Rathi and Lee, David M. and Pye, Stephen R. and Gielen, Evelien and Boonen, Steven and Vanderschueren, Dirk and Pendleton, Neil and Finn, Joseph D. and Tajar, Abdelouahid and O'Connell, Matthew D. L. and Rockwood, Kenneth and Bartfai, Gyoergy and Casanueva, Felipe F. and Forti, Gianni and Giwercman, Aleksander and Han, Thang S. and Huhtaniemi, Ilpo T. and Kula, Krzysztof and Lean, Michael E. J. and Punab, Margus and Wu, Frederick C. W. and O'Neill, Terence W.},
  issn         = {1872-6976},
  keyword      = {Frailty index,Frailty phenotype,Mortality,Population-based,Male,health,Aging},
  language     = {eng},
  number       = {3},
  pages        = {360--368},
  publisher    = {Elsevier},
  series       = {Archives of Gerontology and Geriatrics},
  title        = {The ability of three different models of frailty to predict all-cause mortality: Results from the European Male Aging Study (EMAS)},
  url          = {http://dx.doi.org/10.1016/j.archger.2013.06.010},
  volume       = {57},
  year         = {2013},
}