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Development of a frailty index for patients with coronary artery disease

Elizabeth A Freiheit1, David B Hogan, Misha Eliasziw

  • 1Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. efreihei@ucalgary.ca

Journal of the American Geriatrics Society
|July 17, 2010
PubMed

Insights

A new frailty index accurately predicts disability and poor quality of life in older adults with coronary artery disease (CAD). This brief tool combines physical, cognitive, and psychosocial factors for better patient outcomes.

Area of Science:

  • Gerontology
  • Cardiology
  • Clinical Medicine

Background:

  • Older adults with coronary artery disease (CAD) are at risk for adverse outcomes.
  • Assessing frailty is crucial for predicting disability and health-related quality of life (HRQL).

Purpose of the Study:

  • To develop and validate a brief frailty index for older patients with CAD undergoing coronary angiography.
  • To assess the index's ability to predict future disability and decline in HRQL.

Main Methods:

  • Prospective cohort study of 374 patients aged 60+ undergoing cardiac catheterization.
  • Baseline frailty criteria included balance, gait speed, cognition, self-reported health, BMI, depressive symptoms, and living situation.
  • Outcomes assessed at 1 year were dependency in activities of daily living (ADLs) and HRQL.

Main Results:

  • A five-item frailty index (poor balance, abnormal BMI, impaired Trail-Making Test B, depressive symptoms, living alone) predicted ADL decline.
  • The index demonstrated good predictive accuracy (AUC=0.76).
  • Patients with three or more frailty criteria faced significantly higher risks of disability and decreased HRQL.

Conclusions:

  • A brief frailty index incorporating physical, cognitive, and psychosocial factors effectively predicts disability and reduced HRQL in older CAD patients.
  • This index shows potential utility for clinicians and researchers in managing elderly cardiac patients.
  • Further validation of this frailty index is recommended.
Abstract

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