Ming Yang1, Yan Zhuo2, Xiaoyi Hu3, Lingling Xie3. 1. The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China. yangmier@gmail.com. 2. Department of Healthcare, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China. 3. The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China.
Abstract
BACKGROUND: Little is known about frailty in Chinese nursing home residents. AIMS: (1) To evaluate the prevalence of frailty in nursing home residents according to the FI-Lab or FRAIL-NH; and (2) to compare the predictive validity of these two tools for mortality. METHODS: We conducted a prospective study in four nursing homes in China. Frailty was assessed using the fatigue, resistance, ambulation, illness, loss of weight, nutrition, and help with dressing questionnaire (FRAIL-NH) and frailty index based on common laboratory tests (FI-Lab), respectively. The survival status was collected via medical records or telephone interviews. Receiver-operating characteristic (ROC) curves were calculated to estimate the area under the ROC curves (AUCs) for FI-Lab and FRAIL-NH in relation to mortality. Cox proportional hazard models were applied to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality by FRAIL-NH and FI-Lab, separately. RESULTS: We included 329 participants. The FI-Lab score was significantly and strongly associated with the FRAIL-NH score (r = 0.799, p < 0.001). Frailty was defined as the FI-Lab score ≥ 0.3 or the FRAIL-NH score ≥ 6, and the prevalence of frailty was 56.2% and 58.7%, respectively. Seventy-three participants (22.7%) died during the 1-year follow-up. The FI-Lab (AUC 0.700, 95% CI 0.647-0.750) was slightly better than the FRAIL-NH (AUC 0.676, 95% CI 0.622-0.727) for predicting mortality (p = 0.025). After adjusted for age and gender, the increment of the FI-Lab score was associated with mortality (adjusted HR per 0.01 increment in score 1.07, 95% CI 1.05-1.09), the increment of the FRAIL-NH score was also associated with mortality (adjusted HR per 1 increment in score 1.28, 95% CI 1.19-1.46). CONCLUSION: The FI-Lab and FRAIL-NH are valuable for predicting mortality in Chinese nursing home residents.
BACKGROUND: Little is known about frailty in Chinese nursing home residents. AIMS: (1) To evaluate the prevalence of frailty in nursing home residents according to the FI-Lab or FRAIL-NH; and (2) to compare the predictive validity of these two tools for mortality. METHODS: We conducted a prospective study in four nursing homes in China. Frailty was assessed using the fatigue, resistance, ambulation, illness, loss of weight, nutrition, and help with dressing questionnaire (FRAIL-NH) and frailty index based on common laboratory tests (FI-Lab), respectively. The survival status was collected via medical records or telephone interviews. Receiver-operating characteristic (ROC) curves were calculated to estimate the area under the ROC curves (AUCs) for FI-Lab and FRAIL-NH in relation to mortality. Cox proportional hazard models were applied to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality by FRAIL-NH and FI-Lab, separately. RESULTS: We included 329 participants. The FI-Lab score was significantly and strongly associated with the FRAIL-NH score (r = 0.799, p < 0.001). Frailty was defined as the FI-Lab score ≥ 0.3 or the FRAIL-NH score ≥ 6, and the prevalence of frailty was 56.2% and 58.7%, respectively. Seventy-three participants (22.7%) died during the 1-year follow-up. The FI-Lab (AUC 0.700, 95% CI 0.647-0.750) was slightly better than the FRAIL-NH (AUC 0.676, 95% CI 0.622-0.727) for predicting mortality (p = 0.025). After adjusted for age and gender, the increment of the FI-Lab score was associated with mortality (adjusted HR per 0.01 increment in score 1.07, 95% CI 1.05-1.09), the increment of the FRAIL-NH score was also associated with mortality (adjusted HR per 1 increment in score 1.28, 95% CI 1.19-1.46). CONCLUSION: The FI-Lab and FRAIL-NH are valuable for predicting mortality in Chinese nursing home residents.