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

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

doi:10.1007/s40520-020-01478-3

Cited by 23 publications

(24 citation statements)

References 50 publications

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“…Cox proportional hazard models (sex-adjusted) estimated hazard ratios and 95% confidence intervals (HR(95%CI)) of associations between the FI 50y and all-cause mortality between ages 50y-58y. Associations between FI and mortality are commonly examined using a continuous measure [36] or FI categories derived from specific cut-points (e.g. 0-0.1, 0.1-0.2, etc) [2,37,38].…”

Section: Methodsmentioning

confidence: 99%

Early-life socioeconomic position and the accumulation of health-related deficits by midlife in the 1958 British birth cohort study

Rogers

Blodgett

Searle

et al. 2020

Preprint

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Reducing population levels of frailty is an important goal and preventing its development in mid-adulthood could be pivotal. Childhood socioeconomic position (SEP) is associated with a myriad of adult health outcomes but evidence is limited on associations with frailty. Using 1958 British birth cohort data (N=8711), we aimed to: (i) establish the utility of measuring frailty in mid-life, by examining associations between a 34-item frailty index at 50y (FI50y) and mortality over an eight-year follow-up period and (ii) examine associations between early-life SEP and FI50y and investigate whether these associations were explained by adult SEP. Hazard ratios (HRs) for mortality increased with increasing levels of frailty, e.g., HRsex-adjusted was 4.07(95% CI:2.64,6.25) for highest vs. lowest fifth of FI50y. Lower early-life SEP was associated with higher FI50y: per unit decrease in early-life SEP (on a 4-point scale), FI50y increased by 12.7%(10.85%,14.6%) in a model adjusted for early-life covariates. After additional adjustment for adult occupational class and education, the association attenuated to 5.71%(3.71%,7.70%). Findings suggest that early-life SEP is associated with frailty and that adult SEP only partially explains this association. Results highlight the importance of improving socioeconomic circumstances across the life course to reduce inequalities in frailty from mid-adulthood.

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Section: Methodsmentioning

confidence: 99%

Early-life socioeconomic position and the accumulation of health-related deficits by midlife in the 1958 British birth cohort study

Rogers

Blodgett

Searle

et al. 2020

Preprint

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“…In the InCHIANTI study, an Italian prospective cohort study, the FI was operationalized using 42 variables that reflected age-related disease diagnosis, physical function, and cognitive health [ 3 ]. The FI at baseline was predictive of all-cause and cardiovascular disease mortality [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Association of Adherence to the Mediterranean-Style Diet with Lower Frailty Index in Older Adults

et al. 2021

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Identifying modifying protective factors to promote healthy aging is of utmost public health importance. The frailty index (FI) reflects the accumulation of health deficits and is one widely used method to assess health trajectories in aging. Adherence to a Mediterranean-type diet (MTD) has been associated with favorable health trajectories. Therefore, this study explored whether adherence to a MTD is negatively associated with FI in the InCHIANTI study. Participants (n = 485) included individuals over 65 years of age at baseline with complete data over a follow-up period of 10 years. MTD was computed on a scale of 0–9 and categorized based on these scores into three groups of low (≤3), medium (4–5), and high (≥6) adherence. Being in a high or medium adherence group was associated with 0.03 and 0.013 unit lower FI scores over the follow-up period, compared to the low adherence group. In participants with a low FI at baseline, being in a high or medium MTD-adherence group had 0.004 and 0.005 unit/year slower progression of FI compared to the low adherence group. These study results support adherence to a MTD as a protective strategy to maintain a lower FI.

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“…The frailty index (FI) is an often-used instrument to measure frailty, and it is based on the accumulation of deficits [7]. And while it has mostly been used to measure (gradations in) frailty, the FI is a sensitive measure and it encompasses the entire continuum, from fit to frail [12]. In the current study, we will, therefore, use the FI as a measure of frailty as well as vitality.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Frailty and Vitality in Older Adults Aged 75 years and Over: Results from the Longitudinal Aging Study Amsterdam

Breij¹,

Hout

Bruin

et al. 2021

Gerontology

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Introduction: Frailty can be seen as a continuum, from fit to frail. While many recent studies have focused on frailty, much less attention has been paid to the other end of the continuum: the group of older adults that remain (relatively) vital. Moreover, there is a lack of studies on frailty and vitality that investigate predictors from multiple domains of functioning simultaneously. The aim of this study was to identify predictors of frailty as well as vitality among older adults aged 75 years and over. Methods: We used longitudinal data from 569 adults aged ≥75 years who participated in the Longitudinal Aging Study Amsterdam. Predictors from the sociodemographic, social, psychological, lifestyle, and physical domains of functioning were measured at T1 (2008–2009). We used the frailty index (FI) to identify frail (FI ≥ 0.25) and vital (FI ≤ 0.15) respondents at follow-up, 3 years later (T2: 2011–2012). We conducted logistic regression analyses with backward stepwise selection to develop and internally validate our prediction models. Results: The prevalence of frailty in our sample at follow-up was 49.4% and the prevalence of vitality was 18.3%. Predictors of frailty and vitality partly overlapped and included age, depressive symptoms, number of chronic diseases, and self-rated health. We also found predictors that did not overlap. Male sex, moderate alcohol use, more emotional support received, and no hearing problems, were predictors of vitality. Lower cognitive functioning, polypharmacy, and pain were predictors of frailty. The final model for vitality explained 42% of the variance and the final model for frailty explained 48%. Both models had a good discriminative value (area under ROC-curve [AUC] vitality: 0.88; AUC frailty: 0.85). Conclusion: Among older adults aged 75 years and over, predictors of frailty only partially overlap with predictors of vitality. The readily accessible predictors in our models may help to identify older adults who are likely to be vital, or who are at risk of frailty.

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

Cited by 23 publications

References 50 publications

Early-life socioeconomic position and the accumulation of health-related deficits by midlife in the 1958 British birth cohort study

Early-life socioeconomic position and the accumulation of health-related deficits by midlife in the 1958 British birth cohort study

Association of Adherence to the Mediterranean-Style Diet with Lower Frailty Index in Older Adults

Predictors of Frailty and Vitality in Older Adults Aged 75 years and Over: Results from the Longitudinal Aging Study Amsterdam

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