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Related Experiment Video

Updated: Jun 22, 2026

Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
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Developing and validating a frailty score based on patient-reported outcome 3 months after stroke: A Riksstroke-based

Joakim Wallmark1, Marie Wiberg1, Marie Eriksson1

  • 1Department of Statistics, Umeå School of Business, Economics and Statistics, Umeå University, Umeå, Sweden.

Plos One
|February 20, 2026
PubMed
Summary

A new patient-reported frailty score from the Swedish Stroke Register (Riksstroke) effectively predicts mortality after stroke. This tool offers a scalable, cost-effective method for monitoring patient outcomes and improving stroke care quality.

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Area of Science:

  • Gerontology
  • Neurology
  • Health Services Research

Background:

  • Frailty is prevalent post-stroke, significantly impacting patient outcomes.
  • Existing frailty measures are often clinician-rated and time-intensive.
  • Patient-reported outcome measures (PROMs) offer a scalable alternative.

Purpose of the Study:

  • To develop and validate a patient-reported frailty score using the Swedish Stroke Register (Riksstroke).
  • To assess the score's psychometric properties and prognostic validity.

Main Methods:

  • Analysis of 19,470 stroke survivors' responses to nine patient-reported items.
  • Mokken Scale Analysis and exploratory factor analysis for dimensionality.
  • Item response theory (IRT) models, including bifactor analysis, for score computation.
  • Differential item functioning (DIF) analysis for measurement fairness.
  • Prognostic validity assessed via survival analysis (Kaplan-Meier, Cox regression).

Main Results:

  • All items met scalability criteria; factor analysis identified Physical Functioning and Well-being/Mental Health facets.
  • A bifactor IRT model demonstrated the best fit, capturing a general frailty dimension.
  • Minimal DIF observed for sex and education; modest age-related effects.
  • Higher frailty scores significantly correlated with increased all-cause mortality.

Conclusions:

  • A robust, fair, and prognostically valid frailty score can be derived from Riksstroke PROMs.
  • This approach enables efficient, cost-effective frailty monitoring in stroke survivors.
  • The findings support leveraging routine PROMs for quality improvement in stroke care.