A comparison of frailty indexes for the prediction of falls, disability, fractures, and mortality in older men

Kristine E. Ensrud, Susan K. Ewing, Peggy M. Cawthon, Howard A. Fink, Brent C. Taylor, Jane A. Cauley, Thuy Tien Dam, Lynn Marshall, Eric Orwoll, Steven R. Cummings

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Abstract

OBJECTIVES: To compare the validity of a parsimonious frailty index (components: weight loss, inability to rise from a chair, and poor energy (Study of Osteoporotic Fractures (SOF) index)) with that of the more complex Cardiovascular Health Study (CHS) index (components: unintentional weight loss, low grip strength, poor energy, slowness, and low physical activity) for prediction of adverse outcomes in older men. DESIGN: Prospective cohort study. SETTING: Six U.S. centers. PARTICIPANTS: Three thousand one hundred thirty-two men aged 67 and older. MEASUREMENTS: Frailty status categorized as robust, intermediate stage, or frail using the SOF index and criteria similar to those used in CHS index. Falls were reported three times for 1 year. Disability (≥1 new impairments in performing instrumental activities of daily living) ascertained at 1 year. Fractures and deaths ascertained during 3 years of follow-up. Analysis of area under the receiver operating characteristic curve (AUC) statistics compared for models containing the SOF index versus those containing the CHS index. RESULTS: Greater evidence of frailty as defined by either index was associated with greater risk of adverse outcomes. Frail men had a higher age-adjusted risk of recurrent falls (odds ratio (OR)=3.0-3.6), disability (OR=5.3-7.5), nonspine fracture (hazard ratio (HR)=2.2-2.3), and death (HR=2.5-3.5) (P

Original languageEnglish (US)
Pages (from-to)492-498
Number of pages7
JournalJournal of the American Geriatrics Society
Volume57
Issue number3
DOIs
StatePublished - Mar 2009

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Keywords

  • Frailty
  • Hip fracture
  • Mortality
  • Older men

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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