Measuring daily functioning in older persons using a frailty index: a cohort study based on routine primary care data

Area of Science:

• Gerontology
• Health Informatics
• Clinical Research

Background:

• Electronic health records (EHRs) are increasingly utilized for research purposes.
• Extracting complex outcome measures, such as daily functioning, from EHRs remains a challenge.

Purpose of the Study:

• To assess the utility of an electronic frailty index (eFI) derived from routine primary care data as a measure of daily functioning.
• The study focused on community-dwelling older persons aged 75 years and above.

Main Methods:

• A cohort study involving participants from the Integrated Systemic Care for Older People (ISCOPE) trial.
• Daily functioning was measured using the Groningen Activities Restriction Scale (GARS).
• An electronic frailty index (eFI-Utrecht) was computed from EHRs at baseline and 12 months, then compared with GARS.

Main Results:

• The eFI-Utrecht showed responsiveness after major medical events and correlated with age, sex, and living situation.
• However, the correlation between the eFI-Utrecht and GARS for measuring daily functioning was limited.
• Data included 1390 participants (31.4% male, median age 81).

Conclusions:

• The current electronic frailty index is not a suitable measure for daily functioning in older adults.
• New methods are required to effectively extract daily functioning data from routine care data within EHRs for research.
• EHRs need further development to become a valuable data source for geriatric research.