The Multidimensional Prognostic Index Predicts Falls in Older People: An 8-Year Longitudinal Cohort Study of the Osteoarthritis Initiative

Validation and implementation of telephone-administered version of the Multidimensional Prognostic Index (TELE-MPI) for remote monitoring of community-dwelling older adults

“…In contrast with previous evidence on MPI [ 12 ], in this cohort, both MPI and TELE-MPI did not show predictive accuracy for death and access to the emergency department, but this might be explained by limited sample size, relatively short follow-up, different type of setting and potentially by the effect itself of telemedicine program. Previous studies showed that standard MPI is also an independent predictor of depressive disorders and falls [ 28 , 29 ]. In the Irish Longitudinal Study on Ageing, carried out on 1,854 older adults followed-up over two years, higher baseline MPI values were significantly associated with incident depressive symptoms (highest MPI tertile vs. lowest: OR: 2.96; 95% CI 1.50–5.85) [ 28 ].…”

“…In the Irish Longitudinal Study on Ageing, carried out on 1,854 older adults followed-up over two years, higher baseline MPI values were significantly associated with incident depressive symptoms (highest MPI tertile vs. lowest: OR: 2.96; 95% CI 1.50–5.85) [ 28 ]. Evidence from Osteoarthritis Initiative study in 885 community-dwelling older people with knee osteoarthritis or at high risk for this condition showed that subjects in high-risk MPI category (MPI-3) had significantly higher risk of recurrent falls compared to those in MPI-1 category (OR: 5.98; 95% CI 3.29–10.86) during 8-year follow-up [ 29 ]. The present findings may suggest that the telephone-administered version of MPI could have similar efficacy of standard MPI tool in predicting risk of psychiatric disorders and falls.…”

Association Between the Multidimensional Prognostic Index and Mortality During 15 Years of Follow-up in the InCHIANTI Study

“…To calculate the MPI from the data collected on the InCHIANTI study, we used a slightly modified version of the original MPI, namely, we used the MMSE and Charlson Comorbidity Index instead of the Short Portable Mental Status Questionnaire and the Cumulative Illness Rating Scale, respectively, which are included in the original version of the MPI. This approach was possible thanks to the "plasticity" of the MPI, that is, the capacity of the CGA-based MPI to maintain its prognostic properties even if derived from different tools (27,28). In this regard, values to define risks are specific for each population/setting and to the outcome of interest.…”

The challenge of the multifaceted prognosis in the older people and the Multidimensional Prognostic Index

“…A modified MPI, including the mini nutritional assessment short-form (MNA-SF), showed similar degree of accuracy as the original MPI, but could be completed in around 20 min [ 6 ]. Other versions of the MPI have been developed and validated in large populations of community-dwelling older subjects who underwent a standard CGA to be admitted to public health facilities, i.e., homecare services or nursing homes [ 7 ] as well as in population-based cohorts of older subjects living at home or in an institution in Sweden [ 8 ], Italy [ 9 ], Ireland [ 10 ] and in the United States within the framework of the osteo-arthritis initiative (OAI) [ 11 ]. All these studies confirmed the accuracy of the MPI in predicting life expectancy [ 8 , 9 ] and the risk of hospitalization [ 8 ] during long periods of follow-up (from 12 to over 15 years) as well as the long-term risk of incident depression [ 10 ] and falls [ 11 ].…”

“…Other versions of the MPI have been developed and validated in large populations of community-dwelling older subjects who underwent a standard CGA to be admitted to public health facilities, i.e., homecare services or nursing homes [ 7 ] as well as in population-based cohorts of older subjects living at home or in an institution in Sweden [ 8 ], Italy [ 9 ], Ireland [ 10 ] and in the United States within the framework of the osteo-arthritis initiative (OAI) [ 11 ]. All these studies confirmed the accuracy of the MPI in predicting life expectancy [ 8 , 9 ] and the risk of hospitalization [ 8 ] during long periods of follow-up (from 12 to over 15 years) as well as the long-term risk of incident depression [ 10 ] and falls [ 11 ]. Moreover, in the context of the EU co-funded project EFFICHRONIC a self-administered version of the MPI (SELFY_MPI) was developed and validated as screening tool for community-dwelling patients with chronic diseases (or their caregivers) candidate to be managed through a self-management program [ 12 , 13 ]; a short-form version of the SELFY_MPI was developed for older patients who attended an ambulatory visit by their general practitioners [ 14 ].…”