A frailty instrument for primary care: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE).
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Journal ArticleDate:
2010Citation:
Romero-Ortuno R, Walsh CD, Lawlor BA, Kenny RA, A frailty instrument for primary care: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE)., BMC Geriatrics, 10, 1, 2010, 57 - 69Download Item:
Abstract:
Background:
A frailty paradigm would be useful in primary care to identify older people at risk, but appropriate metrics at that level are lacking. We created and validated a simple instrument for frailty screening in Europeans aged [greater than or equal to]50. Our study is based on the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE, http://www.share-project.org), a large population-based survey conducted in 2004-2005 in twelve European countries.
Methods:
Subjects: SHARE Wave 1 respondents (17,304 females and 13,811 males). Measures: five SHARE variables approximating Fried's frailty definition. Analyses (for each gender): 1) estimation of a discreet factor (DFactor) model based on the frailty variables using LatentGOLD(R). A single DFactor with three ordered levels or latent classes (i.e. non-frail, pre-frail and frail) was modelled; 2) the latent classes were characterised against a biopsychosocial range of Wave 1 variables; 3) the prospective mortality risk (unadjusted and age-adjusted) for each frailty class was established on those subjects with known mortality status at Wave 2 (2007-2008) (11,384 females and 9,163 males); 4) two web-based calculators were created for easy retrieval of a subject's frailty class given any five measurements.
Results:
Females: the DFactor model included 15,578 cases (standard R2 = 0.61). All five frailty indicators discriminated well (p < 0.001) between the three classes: non-frail (N = 10,420; 66.9%), pre-frail (N = 4,025; 25.8%), and frail (N = 1,133; 7.3%). Relative to the non-frail class, the age-adjusted Odds Ratio (with 95% Confidence Interval) for mortality at Wave 2 was 2.1 (1.4 - 3.0) in the pre-frail and 4.8 (3.1 - 7.4) in the frail. Males: 12,783 cases (standard R2 = 0.61, all frailty indicators had p < 0.001): non-frail (N = 10,517; 82.3%), pre-frail (N = 1,871; 14.6%), and frail (N = 395; 3.1%); age-adjusted OR (95% CI) for mortality: 3.0 (2.3 - 4.0) in the pre-frail, 6.9 (4.7 - 10.2) in the frail.
Conclusions:
The SHARE Frailty Instrument has sufficient construct and predictive validity, and is readily and freely accessible via web calculators. To our knowledge, SHARE-FI represents the first European research effort towards a common frailty language at the community level.
Sponsor
Grant Number
European Union (EU)
Author's Homepage:
http://people.tcd.ie/lawlorbahttp://people.tcd.ie/rkenny
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Series/Report no:
BMC Geriatrics10
1
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Full text availableKeywords:
Gerontology, frailty paradigmSubject (TCD):
AgeingDOI:
http://dx.doi.org/10.1186/1471-2318-10-57ISSN:
1471-2318Metadata
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