A frailty instrument for primary care: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE).
Affiliation
Department of Medical Gerontology (Trinity College Dublin), Trinity Centre for Health Sciences, St James's Hospital, James's Street, Dublin 8, Ireland. romeror@tcd.ieIssue Date
2010MeSH
AgedAging
Cross-Sectional Studies
Europe
Female
Frail Elderly
Health Status
Health Surveys
Humans
Male
Middle Aged
Primary Health Care
Prospective Studies
Retirement
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A frailty instrument for primary care: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE). 2010, 10:57 BMC GeriatrJournal
BMC geriatricsDOI
10.1186/1471-2318-10-57PubMed ID
20731877Abstract
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 ≥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.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. 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.
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.
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.
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ArticleLanguage
enISSN
1471-2318ae974a485f413a2113503eed53cd6c53
10.1186/1471-2318-10-57
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