Development, Construct Validity, and Predictive Validity of a Continuous Frailty Scale: Results From 2 Large US Cohorts
Year: 2018
Type: article
Abstract: Frailty is an age-related clinical syndrome of decreased resilience to stressors. Among numerous assessments of frailty, the frailty phenotype (FP) scale proposed by Fried et al. has been the most widely used. We aimed to develop a continuous frailty scale that could overcome limitations facing the categorical FP scale and to evaluate its construct validity, predictive validity, and measurement properties. Data were from the Cardiovascular Health Study (n = 4,243) and Health and Retirement Study (n = 7,600), both conducted in the United States. Frailty was conceptualized as a continuous construct, assessed by 5 measures used in the FP scale: gait speed, grip strength, exhaustion, physical activity, and weight loss. We used confirmatory factor analysis to investigate the relationship between the 5 indicators and the latent frailty construct. We examined the association of the continuous frailty scale with mortality and disability. The unidimensional model fit the data satisfactorily; similar factor structure was observed across 2 cohorts. Gait speed and weight loss were the strongest and weakest indicators, respectively; grip strength, exhaustion, and physical activity had similar strength in measuring frailty. In each cohort, the continuous frailty scale was strongly associated with mortality and disability and continued to be associated with outcomes among robust and prefrail persons classified by the FP scale.
Source: American Journal of Epidemiology
DOI: 10.1093/aje/kwy041
Language: English
Topic: Frailty in Older Adults
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: John A. Hartford Foundation, American Federation for Aging Research, Hartford Foundation for Public Giving, Atlantic Philanthropies, Harvard University, Johns Hopkins University, University of Pittsburgh, Oregon State University, Duke Kunshan University, National Institutes of Health, School of Medicine, Johns Hopkins University, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Neurological Disorders and Stroke
Awards: G1023702118, G1097528416, G1216065370, G1220223050, G125972088, CORONARY HEART DISEASE AND STROKE, CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84, G1401438683, G1438302022, CORONARY HEART DISEASE AND STROKE, Development and Validation of a Frailty Index Using Claims Data for Pharmacoepidemiologic Studies in Older Adults, G1726490033, G1907275479, G2194386449, CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84, G2376260599, G2391884931, G2404385439, CORONARY HEART DISEASE &STROKE IN THE ELDERLY, G270907595, G2800149121, G2899267414, G3007488127, G3045517347, G3137375862, G3220743633, G322252321, G34347772, CHS research resources for the cardiovascular health of older adults, CENTRAL BLOOD ANALYSIS LABORATORY FOR CHS, Frailty Assessment: Matching Simplification Efforts to Clinical Aims, G4219624527, G423252844, G4622379297, G4942589162, G5145575165, G544148272, G5479317095, G581887176, CHS Events Follow-up Study, G6226795708, G6706757010, CHS-Transition Phase, G7176672723, G7217924807, G7244861316, G7415749889, G764651519, G766700449, G766843672, Exceptional Survival: Trajectories to Functional Aging (CHS All Stars), G806768229, G8068269535, A New Paradigm for Hypertension in the Elderly- Beyond Age, G8892155751, G905887895
OpenAlex ID: W2802367223