Operationalization of a frailty index among older adults in the InCHIANTI study: predictive ability for all-cause and cardiovascular disease mortality

Emiel O. Hoogendijk; Sari Stenholm; Luigi Ferrucci; Stefania Bandinelli; Marco Inzitari; Matteo Cesari

doi:10.1007/s40520-020-01478-3

journal article Open Access Jan 31, 2020

Operationalization of a frailty index among older adults in the InCHIANTI study: predictive ability for all-cause and cardiovascular disease mortality

Emiel O. Hoogendijk Sari Stenholm

Luigi Ferrucci

Stefania Bandinelli

Marco Inzitari Matteo Cesari

Aging Clinical and Experimental Research Vol. 32 No. 6 pp. 1025-1034 · Springer Science and Business Media LLC

View at Publisher Save 10.1007/s40520-020-01478-3

Abstract

Abstract
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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Details

Published: Jan 31, 2020
Vol/Issue: 32(6)
Pages: 1025-1034
License: View

Authors

Department of Public Health (K.S., S.S.), University of Turku and Turku University Hospital, Finland.; Centre for Population Health Research (K.S., S.S.), University of Turku and Turku University Hospital, Finland.

REFiT Aging Research Group, Parc Sanitari Pere Virgili and Vall d’Hebron Institute of Research (VHIR) , Barcelona , Spain; Ehealth Lab Research Group, School of Health Sciences, Universitat Oberta de Catalunya , Barcelona , Spain

M

Matteo Cesari

Cite This Article

Emiel O. Hoogendijk, Sari Stenholm, Luigi Ferrucci, et al. (2020). Operationalization of a frailty index among older adults in the InCHIANTI study: predictive ability for all-cause and cardiovascular disease mortality. Aging Clinical and Experimental Research, 32(6), 1025-1034. https://doi.org/10.1007/s40520-020-01478-3

Operationalization of a frailty index among older adults in the InCHIANTI study: predictive ability for all-cause and cardiovascular disease mortality

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