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A “snap-shot” visual estimation of health and objectively measured frailty : capturing general health in aging older women

Bartosch, Patrik LU ; Malmgren, Linnea LU orcid ; Gerdhem, Paul LU ; Kristensson, Jimmie LU ; McGuigan, Fiona Elizabeth LU orcid and Akesson, Kristina Eva LU (2022) In Aging clinical and experimental research 34(7). p.1663-1671
Abstract

Background: In clinic, a subjective visual estimation of a patient’s general health often guides interventions, yet little is known of how this assessment relates to objectively measured frailty. Aims: To characterize the relationship between these two assessments and explore the implication of discordance. Methods: The study was performed in the OPRA cohort of 75-year old community-dwelling women (n = 1044). Visual perception of health (VPH) was estimated within 15 s from first sight and stratified into tertiles (poor/intermediate/good health). Frailty was measured using a frailty index (FI) (scored 0.0–1.0) and stratified into tertiles: ‘frail’ (≥ 0.22), ‘pre-frail’ (0.13–0-21) and ‘non-frail’ (≤ 0.12). Association between VPH and FI... (More)

Background: In clinic, a subjective visual estimation of a patient’s general health often guides interventions, yet little is known of how this assessment relates to objectively measured frailty. Aims: To characterize the relationship between these two assessments and explore the implication of discordance. Methods: The study was performed in the OPRA cohort of 75-year old community-dwelling women (n = 1044). Visual perception of health (VPH) was estimated within 15 s from first sight and stratified into tertiles (poor/intermediate/good health). Frailty was measured using a frailty index (FI) (scored 0.0–1.0) and stratified into tertiles: ‘frail’ (≥ 0.22), ‘pre-frail’ (0.13–0-21) and ‘non-frail’ (≤ 0.12). Association between VPH and FI and with 10-year mortality was evaluated using Kaplan Meier curves and Cox proportional hazard models. Results: VPH and FI correlated, but was strongest in those perceived to be in poor health (rs = 0.424, p < 0.001). Approximately half of these women were also objectively frail (53.7%). Similarly, 50.7% perceived to be in good health were also objectively non-frail. However, for one in ten, perceived health was discordant with measured frailty. Subjective and objective measures were associated with mortality, but VPH lacked discrimination in healthier looking women (p = 0.372) compared to FI (p = 0.002). Discussion: Detecting pre-frailty is important to prevent or slow the transition into a frail state. The frailest can be identified with a visual estimation, but only objective frailty assessments can reliably identity pre-frailty. Conclusions: A visual estimation of health provides valuable complementary information on health, whereas objective assessment of frailty has a broader applicability for health in aging.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Community-dwelling, Frailty, General health, Visual perception, Women
in
Aging clinical and experimental research
volume
34
issue
7
pages
1663 - 1671
publisher
Kurtis
external identifiers
  • scopus:85127501567
  • pmid:35332507
ISSN
1594-0667
DOI
10.1007/s40520-022-02106-y
language
English
LU publication?
yes
id
a7bc39eb-52b0-4d70-b7e9-405bfb35234e
date added to LUP
2022-05-16 15:24:05
date last changed
2024-06-21 17:22:37
@article{a7bc39eb-52b0-4d70-b7e9-405bfb35234e,
  abstract     = {{<p>Background: In clinic, a subjective visual estimation of a patient’s general health often guides interventions, yet little is known of how this assessment relates to objectively measured frailty. Aims: To characterize the relationship between these two assessments and explore the implication of discordance. Methods: The study was performed in the OPRA cohort of 75-year old community-dwelling women (n = 1044). Visual perception of health (VPH) was estimated within 15 s from first sight and stratified into tertiles (poor/intermediate/good health). Frailty was measured using a frailty index (FI) (scored 0.0–1.0) and stratified into tertiles: ‘frail’ (≥ 0.22), ‘pre-frail’ (0.13–0-21) and ‘non-frail’ (≤ 0.12). Association between VPH and FI and with 10-year mortality was evaluated using Kaplan Meier curves and Cox proportional hazard models. Results: VPH and FI correlated, but was strongest in those perceived to be in poor health (r<sub>s</sub> = 0.424, p &lt; 0.001). Approximately half of these women were also objectively frail (53.7%). Similarly, 50.7% perceived to be in good health were also objectively non-frail. However, for one in ten, perceived health was discordant with measured frailty. Subjective and objective measures were associated with mortality, but VPH lacked discrimination in healthier looking women (p = 0.372) compared to FI (p = 0.002). Discussion: Detecting pre-frailty is important to prevent or slow the transition into a frail state. The frailest can be identified with a visual estimation, but only objective frailty assessments can reliably identity pre-frailty. Conclusions: A visual estimation of health provides valuable complementary information on health, whereas objective assessment of frailty has a broader applicability for health in aging.</p>}},
  author       = {{Bartosch, Patrik and Malmgren, Linnea and Gerdhem, Paul and Kristensson, Jimmie and McGuigan, Fiona Elizabeth and Akesson, Kristina Eva}},
  issn         = {{1594-0667}},
  keywords     = {{Community-dwelling; Frailty; General health; Visual perception; Women}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{1663--1671}},
  publisher    = {{Kurtis}},
  series       = {{Aging clinical and experimental research}},
  title        = {{A “snap-shot” visual estimation of health and objectively measured frailty : capturing general health in aging older women}},
  url          = {{http://dx.doi.org/10.1007/s40520-022-02106-y}},
  doi          = {{10.1007/s40520-022-02106-y}},
  volume       = {{34}},
  year         = {{2022}},
}