TY - JOUR
T1 - A comparison of frailty indexes for the prediction of falls, disability, fractures, and mortality in older men
AU - Ensrud, Kristine E.
AU - Ewing, Susan K.
AU - Cawthon, Peggy M.
AU - Fink, Howard A.
AU - Taylor, Brent C.
AU - Cauley, Jane A.
AU - Dam, Thuy Tien
AU - Marshall, Lynn M.
AU - Orwoll, Eric S.
AU - Cummings, Steven R.
PY - 2009/3
Y1 - 2009/3
N2 - OBJECTIVES: To compare the validity of a parsimonious frailty index (components: weight loss, inability to rise from a chair, and poor energy (Study of Osteoporotic Fractures (SOF) index)) with that of the more complex Cardiovascular Health Study (CHS) index (components: unintentional weight loss, low grip strength, poor energy, slowness, and low physical activity) for prediction of adverse outcomes in older men. DESIGN: Prospective cohort study. SETTING: Six U.S. centers. PARTICIPANTS: Three thousand one hundred thirty-two men aged 67 and older. MEASUREMENTS: Frailty status categorized as robust, intermediate stage, or frail using the SOF index and criteria similar to those used in CHS index. Falls were reported three times for 1 year. Disability (≥1 new impairments in performing instrumental activities of daily living) ascertained at 1 year. Fractures and deaths ascertained during 3 years of follow-up. Analysis of area under the receiver operating characteristic curve (AUC) statistics compared for models containing the SOF index versus those containing the CHS index. RESULTS: Greater evidence of frailty as defined by either index was associated with greater risk of adverse outcomes. Frail men had a higher age-adjusted risk of recurrent falls (odds ratio (OR)=3.0-3.6), disability (OR=5.3-7.5), nonspine fracture (hazard ratio (HR)=2.2-2.3), and death (HR=2.5-3.5) (P<.001 for all models). AUC comparisons revealed no differences between models with the SOF index and models with the CHS index in discriminating falls (AUC=0.63, P=.97), disability (AUC=0.68, P=.86), nonspine fracture (AUC=0.63, P=.90), or death (AUC=0.71 for model with SOF index and 0.72 for model with CHS index, P=.19). CONCLUSION: The simple SOF index predicts risk of falls, disability, fracture, and mortality in men as well as the more-complex CHS index.
AB - OBJECTIVES: To compare the validity of a parsimonious frailty index (components: weight loss, inability to rise from a chair, and poor energy (Study of Osteoporotic Fractures (SOF) index)) with that of the more complex Cardiovascular Health Study (CHS) index (components: unintentional weight loss, low grip strength, poor energy, slowness, and low physical activity) for prediction of adverse outcomes in older men. DESIGN: Prospective cohort study. SETTING: Six U.S. centers. PARTICIPANTS: Three thousand one hundred thirty-two men aged 67 and older. MEASUREMENTS: Frailty status categorized as robust, intermediate stage, or frail using the SOF index and criteria similar to those used in CHS index. Falls were reported three times for 1 year. Disability (≥1 new impairments in performing instrumental activities of daily living) ascertained at 1 year. Fractures and deaths ascertained during 3 years of follow-up. Analysis of area under the receiver operating characteristic curve (AUC) statistics compared for models containing the SOF index versus those containing the CHS index. RESULTS: Greater evidence of frailty as defined by either index was associated with greater risk of adverse outcomes. Frail men had a higher age-adjusted risk of recurrent falls (odds ratio (OR)=3.0-3.6), disability (OR=5.3-7.5), nonspine fracture (hazard ratio (HR)=2.2-2.3), and death (HR=2.5-3.5) (P<.001 for all models). AUC comparisons revealed no differences between models with the SOF index and models with the CHS index in discriminating falls (AUC=0.63, P=.97), disability (AUC=0.68, P=.86), nonspine fracture (AUC=0.63, P=.90), or death (AUC=0.71 for model with SOF index and 0.72 for model with CHS index, P=.19). CONCLUSION: The simple SOF index predicts risk of falls, disability, fracture, and mortality in men as well as the more-complex CHS index.
KW - Frailty
KW - Hip fracture
KW - Mortality
KW - Older men
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U2 - 10.1111/j.1532-5415.2009.02137.x
DO - 10.1111/j.1532-5415.2009.02137.x
M3 - Article
C2 - 19245414
AN - SCOPUS:61449084711
SN - 0002-8614
VL - 57
SP - 492
EP - 498
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 3
ER -