Frailty Index Predicts All-Cause Mortality for Middle-Aged and Older Taiwanese: Implications for Active-Aging Programs - PubMed (original) (raw)
Frailty Index Predicts All-Cause Mortality for Middle-Aged and Older Taiwanese: Implications for Active-Aging Programs
Shu-Yu Lin et al. PLoS One. 2016.
Abstract
Background: Frailty Index, defined as an individual's accumulated proportion of listed health-related deficits, is a well-established metric used to assess the health status of old adults; however, it has not yet been developed in Taiwan, and its local related structure factors remain unclear. The objectives were to construct a Taiwan Frailty Index to predict mortality risk, and to explore the structure of its factors.
Methods: Analytic data on 1,284 participants aged 53 and older were excerpted from the Social Environment and Biomarkers of Aging Study (2006), in Taiwan. A consensus workgroup of geriatricians selected 159 items according to the standard procedure for creating a Frailty Index. Cox proportional hazard modeling was used to explore the association between the Taiwan Frailty Index and mortality. Exploratory factor analysis was used to identify structure factors and produce a shorter version-the Taiwan Frailty Index Short-Form.
Results: During an average follow-up of 4.3 ± 0.8 years, 140 (11%) subjects died. Compared to those in the lowest Taiwan Frailty Index tertile (< 0.18), those in the uppermost tertile (> 0.23) had significantly higher risk of death (Hazard ratio: 3.2; 95% CI 1.9-5.4). Thirty-five items of five structure factors identified by exploratory factor analysis, included: physical activities, life satisfaction and financial status, health status, cognitive function, and stresses. Area under the receiver operating characteristic curves (C-statistics) of the Taiwan Frailty Index and its Short-Form were 0.80 and 0.78, respectively, with no statistically significant difference between them.
Conclusion: Although both the Taiwan Frailty Index and Short-Form were associated with mortality, the Short-Form, which had similar accuracy in predicting mortality as the full Taiwan Frailty Index, would be more expedient in clinical practice and community settings to target frailty screening and intervention.
Conflict of interest statement
Competing Interests: The authors have declared that no competing interests exist.
Figures
Similar articles
- Socioeconomic status as a moderator between frailty and mortality at old ages.
Gu D, Yang F, Sautter J. Gu D, et al. BMC Geriatr. 2016 Aug 9;16:151. doi: 10.1186/s12877-016-0322-2. BMC Geriatr. 2016. PMID: 27506542 Free PMC article. - Frailty and Mortality Outcomes in Cognitively Normal Older People: Sex Differences in a Population-Based Study.
Bartley MM, Geda YE, Christianson TJ, Pankratz VS, Roberts RO, Petersen RC. Bartley MM, et al. J Am Geriatr Soc. 2016 Jan;64(1):132-7. doi: 10.1111/jgs.13821. J Am Geriatr Soc. 2016. PMID: 26782862 Free PMC article. - Prevalence and 10-year outcomes of frailty in older adults in relation to deficit accumulation.
Song X, Mitnitski A, Rockwood K. Song X, et al. J Am Geriatr Soc. 2010 Apr;58(4):681-7. doi: 10.1111/j.1532-5415.2010.02764.x. Epub 2010 Mar 22. J Am Geriatr Soc. 2010. PMID: 20345864 - Frailty: a tale of two concepts.
Walston JD, Bandeen-Roche K. Walston JD, et al. BMC Med. 2015 Aug 11;13:185. doi: 10.1186/s12916-015-0420-6. BMC Med. 2015. PMID: 26265077 Free PMC article. Review. - Social frailty increases the risk of all-cause mortality: A longitudinal analysis of the English Longitudinal Study of Ageing.
Ragusa FS, Veronese N, Smith L, Koyanagi A, Dominguez LJ, Barbagallo M. Ragusa FS, et al. Exp Gerontol. 2022 Oct 1;167:111901. doi: 10.1016/j.exger.2022.111901. Epub 2022 Jul 20. Exp Gerontol. 2022. PMID: 35870753 Review.
Cited by
- Data-driven health deficit assessment improves a frailty index's prediction of current cognitive status and future conversion to dementia: results from ADNI.
Engvig A, Maglanoc LA, Doan NT, Westlye LT; Alzheimer’s Disease Neuroimaging Initiative. Engvig A, et al. Geroscience. 2023 Feb;45(1):591-611. doi: 10.1007/s11357-022-00669-2. Epub 2022 Oct 19. Geroscience. 2023. PMID: 36260263 Free PMC article. - Frailty and risks of all-cause and cause-specific death in community-dwelling adults: a systematic review and meta-analysis.
Peng Y, Zhong GC, Zhou X, Guan L, Zhou L. Peng Y, et al. BMC Geriatr. 2022 Sep 2;22(1):725. doi: 10.1186/s12877-022-03404-w. BMC Geriatr. 2022. PMID: 36056319 Free PMC article. - Self-rated health trajectory and frailty among community-dwelling older adults: evidence from the Taiwan Longitudinal Study on Aging (TLSA).
Chu WM, Ho HE, Yeh CJ, Hsiao YH, Hsu PS, Lee SH, Lee MC. Chu WM, et al. BMJ Open. 2021 Aug 6;11(8):e049795. doi: 10.1136/bmjopen-2021-049795. BMJ Open. 2021. PMID: 34362805 Free PMC article. - Derivation and validation of 10-year all-cause and cardiovascular disease mortality prediction model for middle-aged and elderly community-dwelling adults in Taiwan.
Li TC, Li CI, Liu CS, Lin WY, Lin CH, Yang SY, Lin CC. Li TC, et al. PLoS One. 2020 Sep 14;15(9):e0239063. doi: 10.1371/journal.pone.0239063. eCollection 2020. PLoS One. 2020. PMID: 32925948 Free PMC article. - PM2.5 air pollution contributes to the burden of frailty.
Lee WJ, Liu CY, Peng LN, Lin CH, Lin HP, Chen LK. Lee WJ, et al. Sci Rep. 2020 Sep 2;10(1):14478. doi: 10.1038/s41598-020-71408-w. Sci Rep. 2020. PMID: 32879354 Free PMC article.
References
- GBD 2013 DALYs and HALE Collaborators, Murray CJ, Barber RM, et al. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition. Lancet. 2015;386(10009):2145–91. 10.1016/S0140-6736(15)61340-X - DOI - PMC - PubMed
- Lu W-H, Lee W-J, Chen L-K, Hsiao F-Y. Comparisons of annual health care utilization, drug consumption, and medical expenditure between the elderly and general population in Taiwan. Journal of Clinical Gerontology and Geriatrics. 2016;7(2):44–7.
- Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56. - PubMed
MeSH terms
Grants and funding
This study was supported by the Aging and Health Research Center, National Yang Ming University; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, as well as the Ministry of Science and Technology of Taiwan (MOST 104-2633-B-400-001 and MOST 105-3011-B-010-001). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
LinkOut - more resources
Full Text Sources
Other Literature Sources