Which comorbidity index is more appropriate for geriatric patients from the frailty perspective?

Abstract

Objectives: This study examined the relationship between comorbidity indices and comprehensive geriatric assessment including psychologic, social frailty, and geropsychiatric evaluation. Methods: A cross-sectional analysis was conducted with 136 community-dwelling older adults. The relationship of 4 comorbidity indices (CIRS-G, ACCI, GIC, ICED) with 3 different frailty scales (FRAIL, CFS, TFI) was examined.Results: Overall, 58.8% of the participants were living with frailty according to the TFI, 47.7% of them living with psychological frailty, and 28.6% of them living with social frailty. There were signi cant and moderate correlations between CIRS-G and FRAIL, CFS and TFI total scores, TFI-Psychological scores and TFI-Social scores (respectively; p<0.001, r = 0.530; p<0.001, r = 0.471; p<0.001, r = 0.535; p<0.001, r = 0.402; p= 0.016 r = 0.206). AUC for CIRS-G was calculated as 0.746 among comorbidity indices in predicting the presence of frailty according to the TFI (p<0.001, 95%CI [0.66-0.82]), for ACCI AUC was 0.631 (p=0.01, 95%CI [0.53-0.72]), for GIC AUC was 0.595 (p=0.059, 95%CI [0.49-0.69]), for ICED AUC was 0.666 (p=0.001, 95%CI [0.57-0.75]). Conclusion:The CIRS-G index was found to be superior to other indices in predicting the presence of frailty of comorbidity indices, and only GIC scores showed signi cant results in predicting mortality.However, it would be incomplete to conclude with a comorbidity index alone by ignoring the results of comprehensive geriatric assessment. Key pointsAim: To evaluate the relationship between comorbidity indices and comprehensive geriatric assessment including frailty.Findings: The CIRS-G index was found to be superior to other indices in predicting the presence of frailty of comorbidity indices, and only GIC scores showed signi cant results in predicting mortality Message: Although CIRS-G seems to be the index most associated with comprehensive geriatric assessment, including psychological and social frailty, no single comorbidity index should be recommended for predicting clinical outcomes in older adults.