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A Frailty Instrument for primary care: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE)
BACKGROUND: A frailty paradigm would be useful in primary care to identify older people at risk, but appropriate metrics at that level are lacking. We created and validated a simple instrument for frailty screening in Europeans aged ≥50. Our study is based on the first wave of the Survey of Health,...
Autores principales: | , , , |
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2010
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2939541/ https://www.ncbi.nlm.nih.gov/pubmed/20731877 http://dx.doi.org/10.1186/1471-2318-10-57 |
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author | Romero-Ortuno, Roman Walsh, Cathal D Lawlor, Brian A Kenny, Rose Anne |
author_facet | Romero-Ortuno, Roman Walsh, Cathal D Lawlor, Brian A Kenny, Rose Anne |
author_sort | Romero-Ortuno, Roman |
collection | PubMed |
description | BACKGROUND: A frailty paradigm would be useful in primary care to identify older people at risk, but appropriate metrics at that level are lacking. We created and validated a simple instrument for frailty screening in Europeans aged ≥50. Our study is based on the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE, http://www.share-project.org), a large population-based survey conducted in 2004-2005 in twelve European countries. METHODS: Subjects: SHARE Wave 1 respondents (17,304 females and 13,811 males). Measures: five SHARE variables approximating Fried's frailty definition. Analyses (for each gender): 1) estimation of a discreet factor (DFactor) model based on the frailty variables using LatentGOLD(®). A single DFactor with three ordered levels or latent classes (i.e. non-frail, pre-frail and frail) was modelled; 2) the latent classes were characterised against a biopsychosocial range of Wave 1 variables; 3) the prospective mortality risk (unadjusted and age-adjusted) for each frailty class was established on those subjects with known mortality status at Wave 2 (2007-2008) (11,384 females and 9,163 males); 4) two web-based calculators were created for easy retrieval of a subject's frailty class given any five measurements. RESULTS: Females: the DFactor model included 15,578 cases (standard R(2 )= 0.61). All five frailty indicators discriminated well (p < 0.001) between the three classes: non-frail (N = 10,420; 66.9%), pre-frail (N = 4,025; 25.8%), and frail (N = 1,133; 7.3%). Relative to the non-frail class, the age-adjusted Odds Ratio (with 95% Confidence Interval) for mortality at Wave 2 was 2.1 (1.4 - 3.0) in the pre-frail and 4.8 (3.1 - 7.4) in the frail. Males: 12,783 cases (standard R(2 )= 0.61, all frailty indicators had p < 0.001): non-frail (N = 10,517; 82.3%), pre-frail (N = 1,871; 14.6%), and frail (N = 395; 3.1%); age-adjusted OR (95% CI) for mortality: 3.0 (2.3 - 4.0) in the pre-frail, 6.9 (4.7 - 10.2) in the frail. CONCLUSIONS: The SHARE Frailty Instrument has sufficient construct and predictive validity, and is readily and freely accessible via web calculators. To our knowledge, SHARE-FI represents the first European research effort towards a common frailty language at the community level. |
format | Text |
id | pubmed-2939541 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-29395412010-09-21 A Frailty Instrument for primary care: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE) Romero-Ortuno, Roman Walsh, Cathal D Lawlor, Brian A Kenny, Rose Anne BMC Geriatr Research Article BACKGROUND: A frailty paradigm would be useful in primary care to identify older people at risk, but appropriate metrics at that level are lacking. We created and validated a simple instrument for frailty screening in Europeans aged ≥50. Our study is based on the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE, http://www.share-project.org), a large population-based survey conducted in 2004-2005 in twelve European countries. METHODS: Subjects: SHARE Wave 1 respondents (17,304 females and 13,811 males). Measures: five SHARE variables approximating Fried's frailty definition. Analyses (for each gender): 1) estimation of a discreet factor (DFactor) model based on the frailty variables using LatentGOLD(®). A single DFactor with three ordered levels or latent classes (i.e. non-frail, pre-frail and frail) was modelled; 2) the latent classes were characterised against a biopsychosocial range of Wave 1 variables; 3) the prospective mortality risk (unadjusted and age-adjusted) for each frailty class was established on those subjects with known mortality status at Wave 2 (2007-2008) (11,384 females and 9,163 males); 4) two web-based calculators were created for easy retrieval of a subject's frailty class given any five measurements. RESULTS: Females: the DFactor model included 15,578 cases (standard R(2 )= 0.61). All five frailty indicators discriminated well (p < 0.001) between the three classes: non-frail (N = 10,420; 66.9%), pre-frail (N = 4,025; 25.8%), and frail (N = 1,133; 7.3%). Relative to the non-frail class, the age-adjusted Odds Ratio (with 95% Confidence Interval) for mortality at Wave 2 was 2.1 (1.4 - 3.0) in the pre-frail and 4.8 (3.1 - 7.4) in the frail. Males: 12,783 cases (standard R(2 )= 0.61, all frailty indicators had p < 0.001): non-frail (N = 10,517; 82.3%), pre-frail (N = 1,871; 14.6%), and frail (N = 395; 3.1%); age-adjusted OR (95% CI) for mortality: 3.0 (2.3 - 4.0) in the pre-frail, 6.9 (4.7 - 10.2) in the frail. CONCLUSIONS: The SHARE Frailty Instrument has sufficient construct and predictive validity, and is readily and freely accessible via web calculators. To our knowledge, SHARE-FI represents the first European research effort towards a common frailty language at the community level. BioMed Central 2010-08-24 /pmc/articles/PMC2939541/ /pubmed/20731877 http://dx.doi.org/10.1186/1471-2318-10-57 Text en Copyright ©2010 Romero-Ortuno et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Romero-Ortuno, Roman Walsh, Cathal D Lawlor, Brian A Kenny, Rose Anne A Frailty Instrument for primary care: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE) |
title | A Frailty Instrument for primary care: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE) |
title_full | A Frailty Instrument for primary care: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE) |
title_fullStr | A Frailty Instrument for primary care: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE) |
title_full_unstemmed | A Frailty Instrument for primary care: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE) |
title_short | A Frailty Instrument for primary care: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE) |
title_sort | frailty instrument for primary care: findings from the survey of health, ageing and retirement in europe (share) |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2939541/ https://www.ncbi.nlm.nih.gov/pubmed/20731877 http://dx.doi.org/10.1186/1471-2318-10-57 |
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