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Utility of SCORE2 risk algorithm for predicting life course accelerated frailty and physical function decline
Chenglong Li1,2, Yanjun Ma1,2, Rong Hua1,2
1Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China.
Journal of Cachexia, Sarcopenia and Muscle
|December 26, 2022
Summary
The Systemic Coronary Risk Estimation 2 (SCORE2) algorithm effectively predicts accelerated frailty and physical function decline in older adults. This cardiovascular risk tool demonstrates good accuracy, outperforming the previous SCORE algorithm.
Area of Science:
- Gerontology and Geriatric Medicine
- Cardiovascular Disease Epidemiology
- Public Health and Aging
Background:
- Frailty is a progressive aging process, but its dynamic trajectories over a lifetime and predictability by cardiovascular disease (CVD) risk algorithms remain unclear.
- Understanding these trajectories is crucial for predicting health outcomes in aging populations.
Purpose of the Study:
- To evaluate the predictive capability of the Systemic Coronary Risk Estimation 2 (SCORE2) algorithm for identifying accelerated frailty and physical function decline over the life course.
- To compare the predictive performance of SCORE2 against the precedent SCORE algorithm.
Main Methods:
- Utilized longitudinal data on frailty index (FI) and physical function from the English Longitudinal Study of Ageing (ELSA) and Health and Retirement Study (HRS) cohorts (adults aged ≥50 years).
- Employed group-based trajectory modeling to identify distinct frailty trajectories (stable, moderate, accelerated increase).
- Applied modified Poisson regression and linear mixed models to assess associations between SCORE2 and frailty/physical function trajectories, using ROC analysis to compare AUC for SCORE and SCORE2.
Main Results:
- Three consistent frailty trajectories were identified: stable, moderate, and accelerated frailty increase.
- Each 10% increment in SCORE2 risk was significantly associated with a higher risk of accelerated frailty increase (RR 3.58 in ELSA, 1.61 in HRS) and faster physical function decline.
- SCORE2 demonstrated good predictive accuracy for accelerated frailty increase (AUC 0.759 in ELSA, 0.744 in HRS), outperforming SCORE (AUC 0.729 in ELSA, 0.700 in HRS) in both cohorts.
Conclusions:
- The SCORE2 algorithm shows significant utility in predicting accelerated frailty increase and physical function decline in community-dwelling, non-frail adults aged 50 years and older.
- SCORE2 serves as a valuable tool for risk stratification and potentially for early intervention strategies in aging populations.
Keywords:
AgeingCardiovascular disease riskFrailty trajectoriesHealthy longevityPhysical function declineMore Related Videos
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