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Development and validation of a frailty index compatible with three interRAI assessment instruments
Rebecca Abey-Nesbit1, Ulrich Bergler1, John W Pickering1
1Department of Medicine, University of Otago, Christchurch, New Zealand.
Age and Ageing
|August 5, 2022
Summary
A new Frailty Index (FI) was developed to measure frailty across different care settings. This validated index accurately predicts mortality risk in older adults, supporting progressive ageing care.
Area of Science:
- Gerontology
- Public Health
- Biostatistics
Background:
- Frailty Index (FI) quantifies frailty via accumulated deficits.
- Existing FIs are often setting-specific.
- Need for a universal FI across different care stages.
Purpose of the Study:
- Derive a Frailty Index applicable across three international Residential Assessment Instrument (interRAI) assessments.
- Validate the FI's ability to predict mortality in older adults.
- Assess FI performance across different levels of aged care.
Main Methods:
- Identified and recoded common deficit items from interRAI CA, HC, and LTCF assessments.
- Validated the cumulative deficit FI using New Zealand's older adult needs assessment data.
- Compared FI performance against a validated index in the HC cohort.
Main Results:
- The FI comprises 15 questions across seven domains.
- Mean FI scores varied: CA (0.26), HC (0.36), LTCF (0.41).
- The FI demonstrated good 1-year mortality prediction (AUCs: 0.741, 0.687, 0.674).
Conclusions:
- The multi-instrument FI aligns with expected frailty variations across care settings.
- The FI is appropriately associated with mortality risk at different ageing stages.
- This FI offers a standardized measure for progressive ageing and support needs.
