Format

Send to

Choose Destination
See comment in PubMed Commons below
J Am Geriatr Soc. 2008 May;56(5):898-903. doi: 10.1111/j.1532-5415.2008.01656.x. Epub 2008 Mar 21.

Cumulative deficits better characterize susceptibility to death in elderly people than phenotypic frailty: lessons from the Cardiovascular Health Study.

Author information

1
Center for Population Health and Aging, Duke University, Durham, North Carolina 27708, USA. Alexander.Kulminski@duke.edu

Abstract

OBJECTIVES:

To compare how well frailty measures based on a phenotypic frailty approach proposed in the Cardiovascular Health Study (CHS) and a cumulative deficits approach predict mortality.

DESIGN:

Cohort study.

SETTING:

The main cohort of the CHS.

PARTICIPANTS:

Four thousand seven hundred twenty-one individuals.

MEASUREMENTS:

A phenotypic frailty index (PFI) was defined in the same way as proposed in the CHS: assessing weight loss, exhaustion, low physical activity, slowness, and poor grip strength. A cumulative deficit index (DI) was defined based on 48 elderly deficits (signs, symptoms, impairments, diseases) included in the index, with equal weights.

RESULTS:

Of the 1,073 frailest individuals with the lowest survival, the PFI, categorized as proposed in the CHS into robust, prefrail, and frail categories, underestimated the risk of death for 720 persons, whereas the DI categorized into the same three frailty categories underestimated the mortality risk for 134 persons. The higher power of the DI for discriminating frail individuals in their susceptibility to death also followed from comparison of quasi-instantaneous values of both indices. The three-level DI identified 219 individuals as frail of 361 individuals identified as frail according to the three-level PFI.

CONCLUSION:

The DI can more precisely evaluate chances of death because it assesses a broader spectrum of disorders than the PFI. Both indices appear to be frailty related. Integration of both approaches is highly promising for increasing the precision of discrimination of the risk of death and especially for identification of the most vulnerable elderly people.

PMID:
18363679
PMCID:
PMC2703425
DOI:
10.1111/j.1532-5415.2008.01656.x
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Wiley Icon for PubMed Central
    Loading ...
    Support Center