Measuring frailty using self-report and test-based health measures

O. Theou; M. D.L. O'Connell; B. L. King-Kallimanis; A. M. O'Halloran; K. Rockwood; R. A. Kenny

doi:10.1093/ageing/afv010

Measuring frailty using self-report and test-based health measures

O. Theou, M. D.L. O'Connell, B. L. King-Kallimanis, A. M. O'Halloran, K. Rockwood, R. A. Kenny

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Resumen

Background: previously, frailty indices were constructed using mostly subjective health measures. The reporting error in this type of measure can have implications on the robustness of frailty findings.Objective: to examine whether frailty assessment differs when we construct frailty indices using solely self-reported or test-based health measures.Design: secondary analysis of data from The Irish LongituDinal study on Ageing (TILDA).Subjects and methods: 4,961 Irish residents (mean age: 61.9 ± 8.4; 54.2% women) over the age of 50 years who underwent a health assessment were included in this analysis. We constructed three frailty indices using 33 self-reported health measures (SRFI), 33 test-based health measures (TBFI) and all 66 measures combined (CFI). The 2-year follow-up outcomes examined were all-cause mortality, disability, hospitalisation and falls.Results: all three indices had a right-skewed distribution, an upper limit to frailty, a non-linear increase with age, and had a dose-response relationship with adverse outcomes. Levels of frailty were lower when self-reported items were used (SRFI: 0.12 ± 0.09; TBFI: 0.17 ± 0.15; CFI: 0.14 ± 0.13). Men had slightly higher frailty index scores than women when test-based measures were used (men: 0.17 ± 0.09; women: 0.16 ± 0.10). CFI had the strongest prediction for risk of adverse outcomes (ROC: 0.64-0.81), and age was not a significant predictor when it was included in the regression model.Conclusions: except for sex differences, characteristics of frailty are similar regardless of whether self-reported or test-based measures are used exclusively to construct a frailty index. Where available, self-reported and test-based measures should be combined when trying to identify levels of frailty.

Idioma original	English
Páginas (desde-hasta)	471-477
Número de páginas	7
Publicación	Age and Ageing
Volumen	44
N.º	3
DOI	https://doi.org/10.1093/ageing/afv010
Estado	Published - may. 1 2015

Nota bibliográfica

Funding Information:
This work was supported by the Ireland Canada University Foundation through a Dobbin Scholarship and by a Health Research Award from the Irish Health Research Board. TILDA is funded by the Irish Government, The Atlantic Philanthropies and Irish Life PLC. O.T. is supported by a Banting Postdoctoral Fellowship. B.K.K. has received funding from a Career Integration Grant from the European Commission’s Marie Curie Actions (PCIG12-GA-2012-334041 Ageing Network). A.O.H. is funded by a Centre for Ageing Research and Development in Ireland (CARDI) Fellowship under the Ageing Research Leadership Programme (Reference: LP3). K.R. receives funding from the Canadian Institutes of Health Research and from the Dalhousie Medical Research Foundation as Kathryn Allen Weldon Professor of Alzheimer Research. The funding sources had no role in the design, methodology, data analysis or preparation of this manuscript.

Publisher Copyright:
© The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.

ASJC Scopus Subject Areas

Ageing
Geriatrics and Gerontology

PubMed: MeSH publication types

Journal Article
Research Support, Non-U.S. Gov't

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title = "Measuring frailty using self-report and test-based health measures",

abstract = "Background: previously, frailty indices were constructed using mostly subjective health measures. The reporting error in this type of measure can have implications on the robustness of frailty findings.Objective: to examine whether frailty assessment differs when we construct frailty indices using solely self-reported or test-based health measures.Design: secondary analysis of data from The Irish LongituDinal study on Ageing (TILDA).Subjects and methods: 4,961 Irish residents (mean age: 61.9 ± 8.4; 54.2% women) over the age of 50 years who underwent a health assessment were included in this analysis. We constructed three frailty indices using 33 self-reported health measures (SRFI), 33 test-based health measures (TBFI) and all 66 measures combined (CFI). The 2-year follow-up outcomes examined were all-cause mortality, disability, hospitalisation and falls.Results: all three indices had a right-skewed distribution, an upper limit to frailty, a non-linear increase with age, and had a dose-response relationship with adverse outcomes. Levels of frailty were lower when self-reported items were used (SRFI: 0.12 ± 0.09; TBFI: 0.17 ± 0.15; CFI: 0.14 ± 0.13). Men had slightly higher frailty index scores than women when test-based measures were used (men: 0.17 ± 0.09; women: 0.16 ± 0.10). CFI had the strongest prediction for risk of adverse outcomes (ROC: 0.64-0.81), and age was not a significant predictor when it was included in the regression model.Conclusions: except for sex differences, characteristics of frailty are similar regardless of whether self-reported or test-based measures are used exclusively to construct a frailty index. Where available, self-reported and test-based measures should be combined when trying to identify levels of frailty.",

author = "O. Theou and O'Connell, {M. D.L.} and King-Kallimanis, {B. L.} and O'Halloran, {A. M.} and K. Rockwood and Kenny, {R. A.}",

note = "Funding Information: This work was supported by the Ireland Canada University Foundation through a Dobbin Scholarship and by a Health Research Award from the Irish Health Research Board. TILDA is funded by the Irish Government, The Atlantic Philanthropies and Irish Life PLC. O.T. is supported by a Banting Postdoctoral Fellowship. B.K.K. has received funding from a Career Integration Grant from the European Commission{\textquoteright}s Marie Curie Actions (PCIG12-GA-2012-334041 Ageing Network). A.O.H. is funded by a Centre for Ageing Research and Development in Ireland (CARDI) Fellowship under the Ageing Research Leadership Programme (Reference: LP3). K.R. receives funding from the Canadian Institutes of Health Research and from the Dalhousie Medical Research Foundation as Kathryn Allen Weldon Professor of Alzheimer Research. The funding sources had no role in the design, methodology, data analysis or preparation of this manuscript. Publisher Copyright: {\textcopyright} The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.",

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AU - O'Connell, M. D.L.

AU - King-Kallimanis, B. L.

AU - O'Halloran, A. M.

AU - Rockwood, K.

AU - Kenny, R. A.

N1 - Funding Information: This work was supported by the Ireland Canada University Foundation through a Dobbin Scholarship and by a Health Research Award from the Irish Health Research Board. TILDA is funded by the Irish Government, The Atlantic Philanthropies and Irish Life PLC. O.T. is supported by a Banting Postdoctoral Fellowship. B.K.K. has received funding from a Career Integration Grant from the European Commission’s Marie Curie Actions (PCIG12-GA-2012-334041 Ageing Network). A.O.H. is funded by a Centre for Ageing Research and Development in Ireland (CARDI) Fellowship under the Ageing Research Leadership Programme (Reference: LP3). K.R. receives funding from the Canadian Institutes of Health Research and from the Dalhousie Medical Research Foundation as Kathryn Allen Weldon Professor of Alzheimer Research. The funding sources had no role in the design, methodology, data analysis or preparation of this manuscript. Publisher Copyright: © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.

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N2 - Background: previously, frailty indices were constructed using mostly subjective health measures. The reporting error in this type of measure can have implications on the robustness of frailty findings.Objective: to examine whether frailty assessment differs when we construct frailty indices using solely self-reported or test-based health measures.Design: secondary analysis of data from The Irish LongituDinal study on Ageing (TILDA).Subjects and methods: 4,961 Irish residents (mean age: 61.9 ± 8.4; 54.2% women) over the age of 50 years who underwent a health assessment were included in this analysis. We constructed three frailty indices using 33 self-reported health measures (SRFI), 33 test-based health measures (TBFI) and all 66 measures combined (CFI). The 2-year follow-up outcomes examined were all-cause mortality, disability, hospitalisation and falls.Results: all three indices had a right-skewed distribution, an upper limit to frailty, a non-linear increase with age, and had a dose-response relationship with adverse outcomes. Levels of frailty were lower when self-reported items were used (SRFI: 0.12 ± 0.09; TBFI: 0.17 ± 0.15; CFI: 0.14 ± 0.13). Men had slightly higher frailty index scores than women when test-based measures were used (men: 0.17 ± 0.09; women: 0.16 ± 0.10). CFI had the strongest prediction for risk of adverse outcomes (ROC: 0.64-0.81), and age was not a significant predictor when it was included in the regression model.Conclusions: except for sex differences, characteristics of frailty are similar regardless of whether self-reported or test-based measures are used exclusively to construct a frailty index. Where available, self-reported and test-based measures should be combined when trying to identify levels of frailty.

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Measuring frailty using self-report and test-based health measures

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ASJC Scopus Subject Areas

PubMed: MeSH publication types

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