Development and validation of a frailty index in the Longitudinal Aging Study Amsterdam

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Frailty is a state of increased vulnerability to adverse outcomes. The frailty index (FI), defined by the deficit accumulation approach, is a sensitive instrument to measure levels of frailty, and therefore important for longitudinal studies of aging. Aims: To develop an FI in the Longitudinal Aging Study Amsterdam (LASA), and to examine the predictive validity of this FI for 19-year mortality. Methods: LASA is an ongoing study among Dutch older adults, based on a nationally representative sample. A 32-item FI (LASA–FI) was developed at the second LASA measurement wave (1995–1996) among 2218 people aged 57–88 years. An FI score between 0 and 1 was calculated for each individual. The LASA–FI included health deficits from the physical, mental and cognitive domain and can be constructed for most LASA measurement waves. Associations with 19-year mortality were assessed using Kaplan–Meier curves and Cox proportional hazards models. Results: The mean LASA–FI score was 0.19 (SD = 0.12), with a 99% upper limit of 0.53. Scores were higher in women than men (women = 0.20, SD = 0.13 vs. men = 0.17, SD = 0.11, p < 0.001). The average age-related increase in the log-transformed LASA–FI score was 3.5% per year. In a model adjusted for age and sex, the FI score was significantly associated with 19-year all-cause mortality (HR per 0.01 = 1.03, 95% CI 1.03–1.04, p < 0.001). Discussion/conclusions: The key characteristics of the LASA–FI were in line with findings from previous FI studies in population-based samples of older people. The LASA–FI score was associated with mortality and may serve as an internal and external reference value.

Original languageEnglish
Pages (from-to)927-933
Number of pages7
JournalAging Clinical and Experimental Research
Volume29
Issue number5
DOIs
Publication statusPublished - 1 Oct 2017

Cite this

@article{d87e074238074d90a3a11f47338f4051,
title = "Development and validation of a frailty index in the Longitudinal Aging Study Amsterdam",
abstract = "Background: Frailty is a state of increased vulnerability to adverse outcomes. The frailty index (FI), defined by the deficit accumulation approach, is a sensitive instrument to measure levels of frailty, and therefore important for longitudinal studies of aging. Aims: To develop an FI in the Longitudinal Aging Study Amsterdam (LASA), and to examine the predictive validity of this FI for 19-year mortality. Methods: LASA is an ongoing study among Dutch older adults, based on a nationally representative sample. A 32-item FI (LASA–FI) was developed at the second LASA measurement wave (1995–1996) among 2218 people aged 57–88 years. An FI score between 0 and 1 was calculated for each individual. The LASA–FI included health deficits from the physical, mental and cognitive domain and can be constructed for most LASA measurement waves. Associations with 19-year mortality were assessed using Kaplan–Meier curves and Cox proportional hazards models. Results: The mean LASA–FI score was 0.19 (SD = 0.12), with a 99{\%} upper limit of 0.53. Scores were higher in women than men (women = 0.20, SD = 0.13 vs. men = 0.17, SD = 0.11, p < 0.001). The average age-related increase in the log-transformed LASA–FI score was 3.5{\%} per year. In a model adjusted for age and sex, the FI score was significantly associated with 19-year all-cause mortality (HR per 0.01 = 1.03, 95{\%} CI 1.03–1.04, p < 0.001). Discussion/conclusions: The key characteristics of the LASA–FI were in line with findings from previous FI studies in population-based samples of older people. The LASA–FI score was associated with mortality and may serve as an internal and external reference value.",
keywords = "Deficit accumulation, Frail elderly, Frailty index, Longitudinal study, Mortality",
author = "Hoogendijk, {Emiel O.} and Olga Theou and Kenneth Rockwood and Onwuteaka-Philipsen, {Bregje D.} and Deeg, {Dorly J.H.} and Martijn Huisman",
year = "2017",
month = "10",
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language = "English",
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Development and validation of a frailty index in the Longitudinal Aging Study Amsterdam. / Hoogendijk, Emiel O.; Theou, Olga; Rockwood, Kenneth; Onwuteaka-Philipsen, Bregje D.; Deeg, Dorly J.H.; Huisman, Martijn.

In: Aging Clinical and Experimental Research, Vol. 29, No. 5, 01.10.2017, p. 927-933.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Development and validation of a frailty index in the Longitudinal Aging Study Amsterdam

AU - Hoogendijk, Emiel O.

AU - Theou, Olga

AU - Rockwood, Kenneth

AU - Onwuteaka-Philipsen, Bregje D.

AU - Deeg, Dorly J.H.

AU - Huisman, Martijn

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Background: Frailty is a state of increased vulnerability to adverse outcomes. The frailty index (FI), defined by the deficit accumulation approach, is a sensitive instrument to measure levels of frailty, and therefore important for longitudinal studies of aging. Aims: To develop an FI in the Longitudinal Aging Study Amsterdam (LASA), and to examine the predictive validity of this FI for 19-year mortality. Methods: LASA is an ongoing study among Dutch older adults, based on a nationally representative sample. A 32-item FI (LASA–FI) was developed at the second LASA measurement wave (1995–1996) among 2218 people aged 57–88 years. An FI score between 0 and 1 was calculated for each individual. The LASA–FI included health deficits from the physical, mental and cognitive domain and can be constructed for most LASA measurement waves. Associations with 19-year mortality were assessed using Kaplan–Meier curves and Cox proportional hazards models. Results: The mean LASA–FI score was 0.19 (SD = 0.12), with a 99% upper limit of 0.53. Scores were higher in women than men (women = 0.20, SD = 0.13 vs. men = 0.17, SD = 0.11, p < 0.001). The average age-related increase in the log-transformed LASA–FI score was 3.5% per year. In a model adjusted for age and sex, the FI score was significantly associated with 19-year all-cause mortality (HR per 0.01 = 1.03, 95% CI 1.03–1.04, p < 0.001). Discussion/conclusions: The key characteristics of the LASA–FI were in line with findings from previous FI studies in population-based samples of older people. The LASA–FI score was associated with mortality and may serve as an internal and external reference value.

AB - Background: Frailty is a state of increased vulnerability to adverse outcomes. The frailty index (FI), defined by the deficit accumulation approach, is a sensitive instrument to measure levels of frailty, and therefore important for longitudinal studies of aging. Aims: To develop an FI in the Longitudinal Aging Study Amsterdam (LASA), and to examine the predictive validity of this FI for 19-year mortality. Methods: LASA is an ongoing study among Dutch older adults, based on a nationally representative sample. A 32-item FI (LASA–FI) was developed at the second LASA measurement wave (1995–1996) among 2218 people aged 57–88 years. An FI score between 0 and 1 was calculated for each individual. The LASA–FI included health deficits from the physical, mental and cognitive domain and can be constructed for most LASA measurement waves. Associations with 19-year mortality were assessed using Kaplan–Meier curves and Cox proportional hazards models. Results: The mean LASA–FI score was 0.19 (SD = 0.12), with a 99% upper limit of 0.53. Scores were higher in women than men (women = 0.20, SD = 0.13 vs. men = 0.17, SD = 0.11, p < 0.001). The average age-related increase in the log-transformed LASA–FI score was 3.5% per year. In a model adjusted for age and sex, the FI score was significantly associated with 19-year all-cause mortality (HR per 0.01 = 1.03, 95% CI 1.03–1.04, p < 0.001). Discussion/conclusions: The key characteristics of the LASA–FI were in line with findings from previous FI studies in population-based samples of older people. The LASA–FI score was associated with mortality and may serve as an internal and external reference value.

KW - Deficit accumulation

KW - Frail elderly

KW - Frailty index

KW - Longitudinal study

KW - Mortality

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U2 - 10.1007/s40520-016-0689-0

DO - 10.1007/s40520-016-0689-0

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JO - Aging - Clinical and Experimental Research

JF - Aging - Clinical and Experimental Research

SN - 1594-0667

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