Prediction of Mortality in Iranian Elderly Using Frailty Index

Frailty in older adults can lead to severe outcomes such as early death, loss of function, and mental health issues. This study aims to predict mortality rates in elderly Iranians using the Frailty Index.

This retrospective cohort study analyzed data from the Sina healthcare system, focusing on individuals aged 60 and above residing in nursing homes from 2020 to 2023. A total of 3554 elderly individuals were included, with frailty assessed using Fried's scale. Data analysis was performed using Python 3.12, utilizing Kaplan-Meier survival analysis, log-rank tests, and Cox regression models to evaluate survival rates and the impact of frailty on mortality.

Of the 3,554 individuals assessed, 1,830 (51.50%) were identified as frail, and 36.50% of the total participants died during the follow-up period. The cumulative survival rates for frail individuals at 365,730, and 920 days were 0.62, 0.47, and 0.46, respectively, which were lower than those classified as healthy. Multivariable Cox regression analysis showed that frail individuals had a 2.04 times higher risk of mortality compared to healthy individuals, adjusting for confounding variables. Significant factors associated with increased mortality included being female, age over 70, and presence of co-morbidities, while literacy was identified as a protective factor.

Frailty is strongly associated with increased mortality risk in the elderly. The frailty index is an effective predictor of mortality, highlighting the need for early identification and management of frailty to improve health outcomes in this population.