TY - JOUR
T1 - The ability of four frailty screening instruments to predict mortality, hospitalization and dependency in (instrumental) activities of daily living
AU - Veld, Linda P. M. Op het
AU - Beurskens, Anna J. H. M.
AU - de Vet, Henrica C. W.
AU - van Kuijk, Sander M. J.
AU - Hajema, KlaasJan
AU - Kempen, Gertrudis I. J. M.
AU - van Rossum, Erik
N1 - Funding Information:
We thank all participants for filling out the questionnaires. The Community Health Services in Limburg are acknowledged for providing baseline data and the possibility to create the cohort. We thank the center for data and information management of Maastricht University, MEMIC, for their data management support. This project was funded by Nationaal Regieorgaan Praktijkgericht Onderzoek SIA (Project No. PRO-1-007) and Zuyd University of Applied Sciences. Both organizations had no role in study design, in the collection, analyses and interpretation of data and in writing the manuscript.
Publisher Copyright:
© 2019, The Author(s).
PY - 2019/9
Y1 - 2019/9
N2 - The aim of this study was to assess the predictive ability of the frailty phenotype (FP), Groningen Frailty Indicator (GFI), Tilburg Frailty Indicator (TFI) and frailty index (FI) for the outcomes mortality, hospitalization and increase in dependency in (instrumental) activities of daily living ((I)ADL) among older persons. This prospective cohort study with 2-year follow-up included 2420 Dutch community-dwelling older people (65+, mean age 76.3 +/- 6.6 years, 39.5% male) who were pre-frail or frail according to the FP. Mortality data were obtained from Statistics Netherlands. All other data were self-reported. Area under the receiver operating characteristic curves (AUC) was calculated for each frailty instrument and outcome measure. The prevalence of frailty, sensitivity and specificity were calculated using cutoff values proposed by the developers and cutoff values one above and one below the proposed ones (0.05 for FI). All frailty instruments poorly predicted mortality, hospitalization and (I)ADL dependency (AUCs between 0.62-0.65, 0.59-0.63 and 0.60-0.64, respectively). Prevalence estimates of frailty in this population varied between 22.2% (FP) and 64.8% (TFI). The FP and FI showed higher levels of specificity, whereas sensitivity was higher for the GFI and TFI. Using a different cutoff point considerably changed the prevalence, sensitivity and specificity. In conclusion, the predictive ability of the FP, GFI, TFI and FI was poor for all outcomes in a population of pre-frail and frail community-dwelling older people. The FP and the FI showed higher values of specificity, whereas sensitivity was higher for the GFI and TFI.
AB - The aim of this study was to assess the predictive ability of the frailty phenotype (FP), Groningen Frailty Indicator (GFI), Tilburg Frailty Indicator (TFI) and frailty index (FI) for the outcomes mortality, hospitalization and increase in dependency in (instrumental) activities of daily living ((I)ADL) among older persons. This prospective cohort study with 2-year follow-up included 2420 Dutch community-dwelling older people (65+, mean age 76.3 +/- 6.6 years, 39.5% male) who were pre-frail or frail according to the FP. Mortality data were obtained from Statistics Netherlands. All other data were self-reported. Area under the receiver operating characteristic curves (AUC) was calculated for each frailty instrument and outcome measure. The prevalence of frailty, sensitivity and specificity were calculated using cutoff values proposed by the developers and cutoff values one above and one below the proposed ones (0.05 for FI). All frailty instruments poorly predicted mortality, hospitalization and (I)ADL dependency (AUCs between 0.62-0.65, 0.59-0.63 and 0.60-0.64, respectively). Prevalence estimates of frailty in this population varied between 22.2% (FP) and 64.8% (TFI). The FP and FI showed higher levels of specificity, whereas sensitivity was higher for the GFI and TFI. Using a different cutoff point considerably changed the prevalence, sensitivity and specificity. In conclusion, the predictive ability of the FP, GFI, TFI and FI was poor for all outcomes in a population of pre-frail and frail community-dwelling older people. The FP and the FI showed higher values of specificity, whereas sensitivity was higher for the GFI and TFI.
KW - Frail older people
KW - Frailty
KW - Predictive value of tests
KW - Screening
KW - Sensitivity
KW - Specificity
KW - OLDER-ADULTS
KW - HEALTH-CARE
KW - DISABILITY
KW - INDICATOR
KW - POPULATION
KW - PREVALENCE
KW - VALIDITY
KW - OUTCOMES
U2 - 10.1007/s10433-019-00502-4
DO - 10.1007/s10433-019-00502-4
M3 - Article
C2 - 31543731
SN - 1613-9372
VL - 16
SP - 387
EP - 394
JO - European Journal of Ageing
JF - European Journal of Ageing
IS - 3
ER -