OBJECTIVES: To analyze the relationship between frailty and survival in older people with intellectual disabilities (IDs). DESIGN: Population-based longitudinal observational study. SETTING: Three Dutch care provider services. PARTICIPANTS: Individuals with borderline to profound ID aged 50 and older (N=982). MEASUREMENTS: A frailty index (FI) including 51 health-related deficits was used to measure frailty. Mean follow-up was 3.3 years. The Cox proportional hazards model was used to evaluate the independent effect of frailty on survival. The discriminative ability of the FI was measured using a receiver operating characteristic (ROC) curve. RESULTS: Greater FI values were associated with greater risk of death, independent of sex, age, level of ID, and Down syndrome. There was a nonlinear increase in risk with increasing FI value. For example, mortality risk was 2.17 times as great (95% confidence interval (CI)=0.95-4.95) for vulnerable individuals (FI 0.20-0.29) and 19.5 (95% CI=9.13-41.8) times as great for moderately frail individuals (FI 0.40-0.49) as for relatively fit individuals (FI<0.20). The area under the ROC curve for 3-year survival was 0.78. CONCLUSION: Although the predictive validity of the FI should be further determined, it was strongly associated with 3-year mortality. Care providers working with people with ID should be able to recognize frail clients and act in an early stage to stop or prevent further decline.
OBJECTIVES: To analyze the relationship between frailty and survival in older people with intellectual disabilities (IDs). DESIGN: Population-based longitudinal observational study. SETTING: Three Dutch care provider services. PARTICIPANTS: Individuals with borderline to profound ID aged 50 and older (N=982). MEASUREMENTS: A frailty index (FI) including 51 health-related deficits was used to measure frailty. Mean follow-up was 3.3 years. The Cox proportional hazards model was used to evaluate the independent effect of frailty on survival. The discriminative ability of the FI was measured using a receiver operating characteristic (ROC) curve. RESULTS: Greater FI values were associated with greater risk of death, independent of sex, age, level of ID, and Down syndrome. There was a nonlinear increase in risk with increasing FI value. For example, mortality risk was 2.17 times as great (95% confidence interval (CI)=0.95-4.95) for vulnerable individuals (FI 0.20-0.29) and 19.5 (95% CI=9.13-41.8) times as great for moderately frail individuals (FI 0.40-0.49) as for relatively fit individuals (FI<0.20). The area under the ROC curve for 3-year survival was 0.78. CONCLUSION: Although the predictive validity of the FI should be further determined, it was strongly associated with 3-year mortality. Care providers working with people with ID should be able to recognize frail clients and act in an early stage to stop or prevent further decline.
Authors: Sandra C M de Haas; Ester A L de Jonge; Trudy Voortman; Jolien Steenweg-de Graaff; Oscar H Franco; M Arfan Ikram; Fernando Rivadeneira; Jessica C Kiefte-de Jong; Josje D Schoufour Journal: Eur J Nutr Date: 2017-07-25 Impact factor: 5.614
Authors: Marleen J de Leeuw; Alyt Oppewal; Roy G Elbers; Mireille W E J Knulst; Marco C van Maurik; Marjoleine C van Bruggen; Thessa I M Hilgenkamp; Patrick J E Bindels; Dederieke A M Maes-Festen Journal: BMJ Open Date: 2022-02-22 Impact factor: 2.692