Validation of “(fr)AGILE”: a quick tool to identify multidimensional frailty in the elderly

Abstract

Background Several tools have been proposed and validated to operationally define frailty. Recently, the Italian Frailty index (IFi), an Italian modified version of Frailty index, has been validated but its use in clinical practice is limited by long time of administration. Therefore, the aim of this study was to create and validate a quick version of the IFi (AGILE). Methods Validation study was performed by administering IFi and AGILE, after a Comprehensive Geriatric Assessment (CGA) in 401 subjects aged 65 or over (77 ± 7 years). AGILE was a 10-items tool created starting from the more predictive items of the four domains of frailty investigated by IFi (mental, physical, socioeconomic and nutritional). AGILE scores were stratified in light, moderate and severe frailty. At 24 months of follow-up, death, disability (taking into account an increase in ADL lost ≥1 from the baseline) and hospitalization were considered. Area under curve (AUC) was evaluated for both IFi and AGILE. Results Administration time was 9.5 ± 3.8 min for IFi administered after a CGA, and 2.4 ± 1.2 min for AGILE, regardless of CGA (p < 0.001). With increasing degree of frailty, prevalence of mortality increased progressively from 6.5 to 41.8% and from 9.0 to 33.3%, disability from 16.1 to 64.2% and from 22.1 to 59.8% and hospitalization from 17.2 to 58.7% and from 27.0 to 52.2% with AGILE and IFi, respectively (p = NS). Relative Risk for each unit of increase in AGILE was 56, 44 and 24% for mortality, disability and hospitalization, respectively and was lower for IFi (8, 7 and 4% for mortality, disability and hospitalization, respectively). The AUC was higher in AGILE vs. IFi for mortality (0.729 vs. 0.698), disability (0.715 vs. 0.682) and hospitalization (0.645 vs. 0.630). Conclusions Our study shows that AGILE is a rapid and effective tool for screening multidimensional frailty, able to predict mortality, disability and hospitalization, especially useful in care settings that require reliable assessment instruments with short administration time.

Transcriptomic analysis of elderly women with low muscle mass: association with immune system pathway

“…Age-related LMM is a multiple factorial geriatric condition that is associated with known age-related conditions [ 5 ]. Despite its prevalence in older population and its impact on patients’ quality of life, cellular and biological processes associated with LMM are not fully investigated.…”

“…Multiple factors are involved in the development of age-related low muscle mass, including several known age-related factors, such as neuromuscular degeneration, abnormal protein turnover, decreased hormone levels and sensitivity, chronic inflammation, oxidative stress, and lifestyle (nutritional status and physical inactivity) [ 5 ]. Despite the well-described contribution of these factors, current therapies are only limited to lifestyle changes by mainly targeting resistance training and/or protein supplementation [ 6 , 7 ].…”

Quality of life after myocardial re-vascularisation in patients with acute coronary syndrome during the coronavirus disease 2019 pandemic: a prospective observational study

“…frailty), -увеличивает уязвимость пациентов к различным стрессовым факторам из-за кумулятивного снижения функционирования разных резервно-адаптационных физиологических систем. До 80 % больных, перенесших ОКС, имеют астенический синдром [12][13][14].…”

Frailty in Acute and Chronic Coronary Syndrome Patients Entering Cardiac Rehabilitation

“…Recently, Liguori et al [ 19 ] proposed a quick tool to identify multidimensional frailty in the elderly derived from the Italian Frailty index (IFi), an Italian modified version of Rockwood’s Frailty index, named AGILE (a 10-item tool created starting from the more predictive items of the four domains of frailty investigated by IFi (mental, physical, socioeconomic and nutritional) [ 19 ]. Main domains and tools for frailty evaluation are reported in Table 1 .…”