TitleValidating a widely used measure of frailty: are all sub-components necessary? Evidence from the Whitehall II cohort study.
Publication TypeJournal Article
Year of Publication2013
AuthorsBouillon, K, Sabia, S, Jokela, M, Gale, CR, Singh-Manoux, A, Shipley, MJ, Kivimäki, M, Batty, GD
JournalAge (Dordr)
Volume35
Issue4
Pagination1457-65
Date Published2013 Aug
ISSN1574-4647
KeywordsAdult, Aged, Aged, 80 and over, Aging, Confidence Intervals, Disabled Persons, Female, Frail Elderly, Geriatric Assessment, Humans, Incidence, Male, Middle Aged, Military Personnel, Prognosis, Proportional Hazards Models, United Kingdom, Walking, Weight Loss
Abstract

There is growing interest in the measurement of frailty in older age. The most widely used measure (Fried) characterizes this syndrome using five components: exhaustion, physical activity, walking speed, grip strength, and weight loss. These components overlap, raising the possibility of using fewer, and therefore making the device more time- and cost-efficient. The analytic sample was 5,169 individuals (1,419 women) from the British Whitehall II cohort study, aged 55 to 79 years in 2007-2009. Hospitalization data were accessed through English national records (mean follow-up 15.2 months). Age- and sex-adjusted Cox models showed that all components were significantly associated with hospitalization, the hazard ratios (HR) ranging from 1.18 (95 % confidence interval = 0.98, 1.41) for grip strength to 1.60 (1.35, 1.90) for usual walking speed. Some attenuation of these effects was apparent following mutual adjustment for frailty components, but the rank order of the strength of association remained unchanged. We observed a dose-response relationship between the number of frailty components and the risk for hospitalization [1 component-HR = 1.10 (0.96, 1.26); 2-HR = 1.52 (1.26, 1.83); 3-5-HR = 2.41 (1.84, 3.16), P trend <0.0001]. A concordance index used to evaluate the predictive power for hospital admissions of individual components and the full scale was modest in magnitude (range 0.57 to 0.58). Our results support the validity of the multi-component frailty measure, but the predictive performance of the measure is poor.

DOI10.1007/s11357-012-9446-2
Alternate JournalAge (Dordr)
PubMed ID22772579
PubMed Central IDPMC3705104
Grant List / / British Heart Foundation / United Kingdom
RG/13/2/30098 / / British Heart Foundation / United Kingdom
MC_UP_A620_1015 / / Medical Research Council / United Kingdom
R01 HL036310 / HL / NHLBI NIH HHS / United States
G19/35 / / Medical Research Council / United Kingdom
G0100222 / / Medical Research Council / United Kingdom
/ / Medical Research Council / United Kingdom
G8802774 / / Medical Research Council / United Kingdom
MC_U147585819 / / Medical Research Council / United Kingdom
G0902037 / / Medical Research Council / United Kingdom
R01 AG034454 / AG / NIA NIH HHS / United States
MC_UP_A620_1014 / / Medical Research Council / United Kingdom
R01 AG013196 / AG / NIA NIH HHS / United States
PG/11/63/29011 / / British Heart Foundation / United Kingdom
R01AG034454 / AG / NIA NIH HHS / United States
R01HL036310 / HL / NHLBI NIH HHS / United States
G0400491 / / Medical Research Council / United Kingdom
/ / Wellcome Trust / United Kingdom
MC_U147585824 / / Medical Research Council / United Kingdom
R01AG013196 / AG / NIA NIH HHS / United States
RG/07/008/23674 / / British Heart Foundation / United Kingdom