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Age Ageing. 2016 Jul;45(4):463-8. doi: 10.1093/ageing/afw054. Epub 2016 Apr 13.

A frailty index based on laboratory deficits in community-dwelling men predicted their risk of adverse health outcomes.

Author information

1
Andrology Research Unit, University of Manchester, Manchester, UK Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
2
Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
3
Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada.
4
Andrology Research Unit, Developmental and Regenerative Biomedicine Research Group, Manchester Academic Health Science Centre (MAHSC), The University of Manchester, Manchester, UK.

Abstract

BACKGROUND:

abnormal laboratory test results accumulate with age and can be common in people with few clinically detectable health deficits. A frailty index (FI) based entirely on common physiological and laboratory tests (FI-Lab) might offer pragmatic and scientific advantages compared with a clinical FI (FI-Clin).

OBJECTIVES:

to compare the FI-Lab with the FI-Clin and to assess their individual and combined relationships with mortality and other adverse health outcomes.

DESIGN AND SUBJECTS:

secondary analysis of the eight-centre, longitudinal European Male Ageing Study (EMAS) of community-dwelling men aged 40-79 at baseline. Follow-up assessment occurred 4.4 ± 0.3 (mean ± SD) years later.

METHODS:

we constructed a 23-item FI using common laboratory tests, blood pressure and pulse (FI-Lab), compared it with a previously validated 39-item FI using self-report and performance-based measures (FI-Clin) and finally combined both FIs to create a 62-item FI-Combined. Outcomes were all-cause mortality, institutionalisation, doctor visits, medication use, self-reported health, falls and fractures.

RESULTS:

the mean FI-Lab score was 0.28 ± 0.11, the FI-Clin was 0.13 ± 0.11 and FI-Combined was 0.19 ± 0.09. Age-adjusted models demonstrated that each FI was associated with mortality [HR (CI) FI-Lab: 1.04 (1.03-1.06); FI-Clin: 1.05 (1.04-1.06); FI-Combined: 1.07 (1.06-1.09)], institutionalisation, doctor visits, medication use, self-reported health and falls. Combined in a model with FI-Clin, the FI-Lab remained independently associated with mortality, institutionalisation, doctor visits, medication use and self-reported health.

CONCLUSIONS:

the FI-Lab detected an increased risk of adverse health outcomes alone and in combination with a clinical FI; further evaluation of the feasibility of the FI-Lab as a frailty screening tool within hospital care settings is needed.

KEYWORDS:

ageing; frail older people; frailty; mortality; pre-clinical frailty

Comment in

PMID:
27076524
DOI:
10.1093/ageing/afw054
[Indexed for MEDLINE]

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