Frailty index as a predictor of mortality: a systematic review and meta-analysis

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Abstract

two popular operational definitions of frailty, the frailty phenotype and Frailty index (FI), are based on different theories. Although FI was shown to be superior in predicting mortality to the frailty phenotype, no meta-analysis on mortality risk according to FI has been found in the literature.

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Most cited references 4

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Prognostic significance of potential frailty criteria.

Marc Rothman, Linda Leo-Summers, Thomas Gill (2008)

To determine the independent prognostic effect of seven potential frailty criteria, including five from the Fried phenotype, on several adverse outcomes. Prospective cohort study. Greater New Haven, Connecticut. Seven hundred fifty-four initially nondisabled, community-living persons aged 70 and older. An assessment of seven potential frailty criteria (slow gait speed, low physical activity, weight loss, exhaustion, weakness, cognitive impairment, and depressive symptoms) was completed at baseline and every 18 months for 72 months. Participants were followed with monthly telephone interviews for up to 96 months to determine the occurrence of chronic disability, long-term nursing home (NH) stays, injurious falls, and death. In analyses adjusted for age, sex, race, education, number of chronic conditions, and the presence of the other potential frailty criteria, three of the five Fried criteria (slow gait speed, low physical activity, and weight loss) were independently associated with chronic disability, long-term NH stays, and death. Slow gait speed was the strongest predictor of chronic disability (hazard ratio (HR)=2.97, 95% confidence interval (CI)=2.32-3.80) and long-term NH stay (HR=3.86, 95% CI=2.23-6.67) and was the only significant predictor of injurious falls (HR=2.19, 95% CI=1.33-3.60). Cognitive impairment was also associated with chronic disability (HR=1.82, 95% CI=1.40-2.38), long-term NH stay (HR=2.64, 95% CI=1.75-3.99), and death (HR=1.54, 95% CI=1.13-2.10), and the magnitude of these associations was comparable with that of weight loss. The results of this study provide strong evidence to support the use of slow gait speed, low physical activity, weight loss, and cognitive impairment as key indicators of frailty while raising concerns about the value of self-reported exhaustion and muscle weakness.

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Frail phenotype and mortality prediction: a systematic review and meta-analysis of prospective cohort studies.

Shu-Fang Chang, Pei-Ling Lin (2015)

This study focused on older adults living in communities, primarily to investigate the relationship between physical frailty and mortality, and secondly to examine gender and age effects on the relationship between frailty and mortality.

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The association between geriatric syndromes and survival.

Robert Kane, Tatyana Shamliyan, Kristine M C Talley … (2012)

To ascertain the effect on survival of eight common geriatric syndromes (multiple comorbidities, cognitive impairment, frailty, disability, sarcopenia, malnutrition, homeostenosis, and chronic inflammation), identified by an expert panel of academic geriatricians.

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Author and article information

Journal

Title: Age and Ageing

Publisher: Oxford University Press (OUP)

ISSN (Print): 0002-0729

ISSN (Electronic): 1468-2834

Publication date Created: March 2018

Publication date Created: March 01 2018

Publication date Created: October 13 2017

Publication date Other: March 2018

Publication date (Print): March 01 2018

Publication date (Electronic): October 13 2017

Volume: 47

Issue: 2

Pages: 193-200

Affiliations

[1 ] Department of Primary Care and Population Health, University College London, Rowland Hill Street, London NW3 2PF, United Kingdom of Great Britain and Northern Ireland

Article

DOI: 10.1093/ageing/afx162

PubMed ID: 29040347

SO-VID: 3588a902-3c22-45d8-8608-6031a47daaae

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