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A reliable measure of frailty for a community dwelling older population
BACKGROUND: Frailty remains an elusive concept despite many efforts to define and measure it. The difficulty in translating the clinical profile of frail elderly people into a quantifiable assessment tool is due to the complex and heterogeneous nature of their health problems. Viewing frailty as a &...
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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/PMC2988728/ https://www.ncbi.nlm.nih.gov/pubmed/21029450 http://dx.doi.org/10.1186/1477-7525-8-123 |
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author | Kamaruzzaman, Shahrul Ploubidis, George B Fletcher, Astrid Ebrahim, Shah |
author_facet | Kamaruzzaman, Shahrul Ploubidis, George B Fletcher, Astrid Ebrahim, Shah |
author_sort | Kamaruzzaman, Shahrul |
collection | PubMed |
description | BACKGROUND: Frailty remains an elusive concept despite many efforts to define and measure it. The difficulty in translating the clinical profile of frail elderly people into a quantifiable assessment tool is due to the complex and heterogeneous nature of their health problems. Viewing frailty as a 'latent vulnerability' in older people this study aims to derive a model based measurement of frailty and examines its internal reliability in community dwelling elderly. METHOD: The British Women's Heart and Health Study (BWHHS) cohort of 4286 women aged 60-79 years from 23 towns in Britain provided 35 frailty indicators expressed as binary categorical variables. These indicators were corrected for measurement error and assigned relative weights in its association with frailty. Exploratory factor analysis (EFA) reduced the data to a smaller number of factors and was subjected to confirmatory factor analysis (CFA)which restricted the model by fitting the EFA-driven structure to observed data. Cox regression analysis compared the hazard ratios for adverse outcomes of the newly developed British frailty index (FI) with a widely known FI. This process was replicated in the MRC Assessment study of older people, a larger cohort drawn from 106 general practices in Britain. RESULTS: Seven factors explained the association between frailty indicators: physical ability, cardiac symptoms/disease, respiratory symptoms/disease, physiological measures, psychological problems, co-morbidities and visual impairment. Based on existing concepts and statistical indices of fit, frailty was best described using a General Specific Model. The British FI would serve as a better population metric than the FI as it enables people with varying degrees of frailty to be better distinguished over a wider range of scores. The British FI was a better independent predictor of all-cause mortality, hospitalization and institutionalization than the FI in both cohorts. CONCLUSIONS: Frailty is a multidimensional concept represented by a wide range of latent (not directly observed) attributes. This new measure provides more precise information than is currently recognized, of which cluster of frailty indicators are important in older people. This study could potentially improve quality of life among older people through targeted efforts in early prevention and treatment of frailty. |
format | Text |
id | pubmed-2988728 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-29887282010-12-06 A reliable measure of frailty for a community dwelling older population Kamaruzzaman, Shahrul Ploubidis, George B Fletcher, Astrid Ebrahim, Shah Health Qual Life Outcomes Research BACKGROUND: Frailty remains an elusive concept despite many efforts to define and measure it. The difficulty in translating the clinical profile of frail elderly people into a quantifiable assessment tool is due to the complex and heterogeneous nature of their health problems. Viewing frailty as a 'latent vulnerability' in older people this study aims to derive a model based measurement of frailty and examines its internal reliability in community dwelling elderly. METHOD: The British Women's Heart and Health Study (BWHHS) cohort of 4286 women aged 60-79 years from 23 towns in Britain provided 35 frailty indicators expressed as binary categorical variables. These indicators were corrected for measurement error and assigned relative weights in its association with frailty. Exploratory factor analysis (EFA) reduced the data to a smaller number of factors and was subjected to confirmatory factor analysis (CFA)which restricted the model by fitting the EFA-driven structure to observed data. Cox regression analysis compared the hazard ratios for adverse outcomes of the newly developed British frailty index (FI) with a widely known FI. This process was replicated in the MRC Assessment study of older people, a larger cohort drawn from 106 general practices in Britain. RESULTS: Seven factors explained the association between frailty indicators: physical ability, cardiac symptoms/disease, respiratory symptoms/disease, physiological measures, psychological problems, co-morbidities and visual impairment. Based on existing concepts and statistical indices of fit, frailty was best described using a General Specific Model. The British FI would serve as a better population metric than the FI as it enables people with varying degrees of frailty to be better distinguished over a wider range of scores. The British FI was a better independent predictor of all-cause mortality, hospitalization and institutionalization than the FI in both cohorts. CONCLUSIONS: Frailty is a multidimensional concept represented by a wide range of latent (not directly observed) attributes. This new measure provides more precise information than is currently recognized, of which cluster of frailty indicators are important in older people. This study could potentially improve quality of life among older people through targeted efforts in early prevention and treatment of frailty. BioMed Central 2010-10-28 /pmc/articles/PMC2988728/ /pubmed/21029450 http://dx.doi.org/10.1186/1477-7525-8-123 Text en Copyright ©2010 Kamaruzzaman 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 Kamaruzzaman, Shahrul Ploubidis, George B Fletcher, Astrid Ebrahim, Shah A reliable measure of frailty for a community dwelling older population |
title | A reliable measure of frailty for a community dwelling older population |
title_full | A reliable measure of frailty for a community dwelling older population |
title_fullStr | A reliable measure of frailty for a community dwelling older population |
title_full_unstemmed | A reliable measure of frailty for a community dwelling older population |
title_short | A reliable measure of frailty for a community dwelling older population |
title_sort | reliable measure of frailty for a community dwelling older population |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2988728/ https://www.ncbi.nlm.nih.gov/pubmed/21029450 http://dx.doi.org/10.1186/1477-7525-8-123 |
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