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Validation of a Brief Form of the Self-Administered Multidimensional Prognostic Index: The SELFY-BRIEF-MPI Project
Wanda Morganti1, Nicola Veronese2, Marina Barbagelata1
1Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Ente Ospedaliero Galliera Hospital, 16128 Genoa, Italy.
Abstract:
In clinical practice, self-administered and brief tools to promptly identify older people at risk of frailty are required. The Multidimensional Prognostic Index (MPI), derived from the Comprehensive Geriatric Assessment (CGA) seems reliable enough to serve this purpose, but despite the several versions developed over the past 15 years, it lacks a self-administered and brief version. In this study, we aimed to evaluate the agreement between an abbreviated form of the SELFY-MPI (i.e., SELFY-BRIEF-MPI) and the standard version of the MPI. Four Italian hospitals consecutively enrolled outpatients and inpatients >65 years. The sample included 105 participants (mean age = 78.8 years, 53.3% females). Overall, the two versions showed non-statistically significant differences (Standard-MPI 0.42 ± 0.19 vs.. SELFY-BRIEF-MPI 0.41 ± 0.18; p = 0.104) and a very strong correlation (R = 0.86, p < 0.001). The Bland-Altman Plot revealed that only 5/105 measurements (4.76%) were outside the limits of agreement. The accuracy of the SELFY-BRIEF-MPI in identifying frail people (defined as a Standard-MPI > 0.66) was optimal (area under the curve, AUC = 0.90, p < 0.001). To predict multidimensional frailty, a SELFY-BRIEF-MPI score of 0.60 exhibited the greatest sensitivity/specificity ratio. In conclusion, the SELFY-BRIEF-MPI reported a good agreement with the standard version of the MPI, indicating its application in the screening of multidimensional frailty among older people.
Insights
A new brief tool, the SELFY-BRIEF-MPI, accurately screens for frailty in older adults. It shows strong agreement with the standard Multidimensional Prognostic Index (MPI), making it useful for clinical practice.
Area of Science:
- Gerontology
- Clinical Geriatrics
- Health Assessment Tools
Background:
- Clinical practice requires efficient tools for identifying frailty risk in older adults.
- The Multidimensional Prognostic Index (MPI), based on Comprehensive Geriatric Assessment (CGA), is a reliable frailty indicator.
- Existing MPI versions lack brevity and self-administration, limiting their clinical utility.
Purpose of the Study:
- To assess the agreement between the abbreviated SELFY-BRIEF-MPI and the standard MPI.
- To validate the SELFY-BRIEF-MPI as a tool for screening multidimensional frailty in older populations.
Main Methods:
- A study involving 105 outpatients and inpatients over 65 years across four Italian hospitals.
- Comparison of scores from the standard MPI and the abbreviated SELFY-BRIEF-MPI.
- Statistical analysis including correlation, Bland-Altman plots, and Receiver Operating Characteristic (ROC) curve analysis to determine accuracy.
Main Results:
- The SELFY-BRIEF-MPI demonstrated strong correlation (R = 0.86) and non-significant differences compared to the standard MPI.
- Only 4.76% of measurements fell outside the limits of agreement.
- The SELFY-BRIEF-MPI showed optimal accuracy (AUC = 0.90) in identifying frail individuals, with a score of 0.60 providing the best sensitivity/specificity.
Conclusions:
- The SELFY-BRIEF-MPI is a valid and reliable abbreviated tool for screening multidimensional frailty.
- Its strong agreement with the standard MPI supports its use in clinical settings for prompt frailty assessment.
- This brief, self-administered tool can improve early identification and management of frailty in older adults.
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