Development and validation of a frailty index in the Longitudinal Aging Study Amsterdam - PubMed (original) (raw)

Development and validation of a frailty index in the Longitudinal Aging Study Amsterdam

Emiel O Hoogendijk et al. Aging Clin Exp Res. 2017 Oct.

Abstract

Background: Frailty is a state of increased vulnerability to adverse outcomes. The frailty index (FI), defined by the deficit accumulation approach, is a sensitive instrument to measure levels of frailty, and therefore important for longitudinal studies of aging.

Aims: To develop an FI in the Longitudinal Aging Study Amsterdam (LASA), and to examine the predictive validity of this FI for 19-year mortality.

Methods: LASA is an ongoing study among Dutch older adults, based on a nationally representative sample. A 32-item FI (LASA-FI) was developed at the second LASA measurement wave (1995-1996) among 2218 people aged 57-88 years. An FI score between 0 and 1 was calculated for each individual. The LASA-FI included health deficits from the physical, mental and cognitive domain and can be constructed for most LASA measurement waves. Associations with 19-year mortality were assessed using Kaplan-Meier curves and Cox proportional hazards models.

Results: The mean LASA-FI score was 0.19 (SD = 0.12), with a 99% upper limit of 0.53. Scores were higher in women than men (women = 0.20, SD = 0.13 vs. men = 0.17, SD = 0.11, p < 0.001). The average age-related increase in the log-transformed LASA-FI score was 3.5% per year. In a model adjusted for age and sex, the FI score was significantly associated with 19-year all-cause mortality (HR per 0.01 = 1.03, 95% CI 1.03-1.04, p < 0.001).

Discussion/conclusions: The key characteristics of the LASA-FI were in line with findings from previous FI studies in population-based samples of older people. The LASA-FI score was associated with mortality and may serve as an internal and external reference value.

Keywords: Deficit accumulation; Frail elderly; Frailty index; Longitudinal study; Mortality.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1

Fig. 1

Distribution of the frailty index at baseline (N = 2218)

Fig. 2

Fig. 2

Average frailty index score by sex and age

Fig. 3

Fig. 3

Kaplan–Meier curves according to frailty index score: proportions of people who survived plotted against time

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