Evaluation of a 3-Item Health Index in Predicting Mortality Risk: A 12-Year Follow-Up Study
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2023Access:
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Knight SP, Ward M, Duggan E, Xue F, Kenny RA, Romero-Ortuno R., Evaluation of a 3-Item Health Index in Predicting Mortality Risk: A 12-Year Follow-Up Study, Diagnostics, 2023Download Item:
218. Diagnostics 3-Item HI FRAILMatics.pdf (PDF) 2.890Mb
Abstract:
This study was carried out using a large cohort (N = 4265; 416 deceased) of older,
community-dwelling adults from The Irish Longitudinal Study on Ageing (TILDA). The study
compared the performance of a new 3-item health index (HI) with two existing measures, the 32-item
frailty index (FI) and the frailty phenotype (FP), in predicting mortality risk. The HI was based
on the objective measurement of resting-state systolic blood pressure sample entropy, sustained
attention reaction time performance, and usual gait speed. Mortality data from a 12-year follow up
period were analyzed using Cox proportional regression. All data processing was performed using
MATLAB and statistical analysis using STATA 15.1. The HI showed good discriminatory power
(AUC = 0.68) for all-cause mortality, similar to FI (AUC = 0.68) and superior to FP (AUC = 0.60). The
HI classified participants into Low-Risk (84%), Medium-Risk (15%), and High-Risk (1%) groups, with
the High-Risk group showing a significant hazard ratio (HR) of 5.91 in the unadjusted model and 2.06
in the fully adjusted model. The HI also exhibited superior predictive performance for cardiovascular
and respiratory deaths (AUC = 0.74), compared with FI (AUC = 0.70) and FP (AUC = 0.64). The HI
High-Risk group had the highest HR (15.10 in the unadjusted and 5.61 in the fully adjusted models)
for cardiovascular and respiratory mortality. The HI remained a significant predictor of mortality
even after comprehensively adjusting for confounding variables. These findings demonstrate the
effectiveness of the 3-item HI in predicting 12-year mortality risk across different causes of death.
The HI performed similarly to FI and FP for all-cause mortality but outperformed them in predicting
cardiovascular and respiratory deaths. Its ability to classify individuals into risk groups offers a
practical approach for clinicians and researchers. Additionally, the development of a user-friendly
MATLAB App facilitates its implementation in clinical settings. Subject to external validation in
clinical research settings, the HI can be more useful than existing frailty measures in the prediction of
cardio-respiratory risk.
Sponsor
Grant Number
Science Foundation Ireland (SFI)
18/FRL/6188
Author's Homepage:
http://people.tcd.ie/romeroorhttp://people.tcd.ie/rkenny
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PUBLISHED
Author: Romero-Ortuno, Roman; Kenny, Rose
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DiagnosticsAvailability:
Full text availableKeywords:
3-item health index, MATLAB health index app, TILDA, Healthcare computer application, Sample entropy, SART, Gait speed, Mortality, FrailtySubject (TCD):
Ageing , Next Generation Medical Devices , Frailty & ResilienceDOI:
https://doi.org/10.3390/diagnostics13172801Licences: