Joshua G Petrie1, Emily T Martin2, Yuwei Zhu3, Dayna G Wyatt4, Anne Kaniclides2, Jill M Ferdinands5, Arnold S Monto2, Christopher Trabue6, H Keipp Talbot7. 1. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, United States. Electronic address: jpetrie@umich.edu. 2. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, United States. 3. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United States. 4. Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States. 5. Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, United States. 6. Department of Medicine, University of Tennessee Health Science Center, Saint Thomas Health, Nashville, TN, United States. 7. Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States; Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, United States.
Abstract
BACKGROUND: Frailty is an important physiologic factor in studies of influenza and influenza vaccines carried out in older adults and hospitalized populations. Unfortunately, comprehensive assessments of frailty requiring physical assessments and extensive medical record review are not often feasible in time- and resource-limited settings common to studies of influenza and influenza vaccines. METHODS: We developed a 5-question frailty short interview, and implemented it in a multicenter, hospital-based study of influenza over two years. Frailty status defined by the frailty short interview was compared to a validated frailty index based on medical record review of 59 parameters. Agreement between the two frailty measures was assessed, and multivariable linear regression models were used to explore differences between the measures. The association between each frailty measure and likelihood of influenza vaccination was also assessed. RESULTS: During the 2015-2016 and 2016-2017 influenza seasons, 2070 adult patients hospitalized with acute respiratory illness were enrolled and included in analyses. Frailty was frequently identified in the study population; 43% of participants were defined as frail by the frailty short interview and 32% by frailty index. Responses to the frailty short interview were only moderately correlated with the frailty index, and agreement between the two frailty measures was low. Women were more likely to be defined as frail by the frailty short interview than men. White individuals were more likely than other races to be defined as frail by the frailty index. Increasing frailty index was associated with increased likelihood of influenza vaccination, but the frailty short interview was not associated with vaccination. CONCLUSIONS: The frailty short interview provided a feasible and consistent measure of frailty across study hospitals and study years. However, its modest correlation with the frailty index and differential association with likelihood of influenza vaccination highlight differences in the conceptualization of frailty.
BACKGROUND: Frailty is an important physiologic factor in studies of influenza and influenza vaccines carried out in older adults and hospitalized populations. Unfortunately, comprehensive assessments of frailty requiring physical assessments and extensive medical record review are not often feasible in time- and resource-limited settings common to studies of influenza and influenza vaccines. METHODS: We developed a 5-question frailty short interview, and implemented it in a multicenter, hospital-based study of influenza over two years. Frailty status defined by the frailty short interview was compared to a validated frailty index based on medical record review of 59 parameters. Agreement between the two frailty measures was assessed, and multivariable linear regression models were used to explore differences between the measures. The association between each frailty measure and likelihood of influenza vaccination was also assessed. RESULTS: During the 2015-2016 and 2016-2017 influenza seasons, 2070 adult patients hospitalized with acute respiratory illness were enrolled and included in analyses. Frailty was frequently identified in the study population; 43% of participants were defined as frail by the frailty short interview and 32% by frailty index. Responses to the frailty short interview were only moderately correlated with the frailty index, and agreement between the two frailty measures was low. Women were more likely to be defined as frail by the frailty short interview than men. White individuals were more likely than other races to be defined as frail by the frailty index. Increasing frailty index was associated with increased likelihood of influenza vaccination, but the frailty short interview was not associated with vaccination. CONCLUSIONS: The frailty short interview provided a feasible and consistent measure of frailty across study hospitals and study years. However, its modest correlation with the frailty index and differential association with likelihood of influenza vaccination highlight differences in the conceptualization of frailty.
Authors: Caitlin Lees; Judith Godin; Janet E McElhaney; Shelly A McNeil; Mark Loeb; Todd F Hatchette; Jason LeBlanc; William Bowie; Guy Boivin; Allison McGeer; André Poirier; Jeff Powis; Makeda Semret; Duncan Webster; Melissa K Andrew Journal: J Infect Dis Date: 2020-07-06 Impact factor: 5.226
Authors: Jill M Ferdinands; Manjusha Gaglani; Shekhar Ghamande; Emily T Martin; Donald Middleton; Arnold S Monto; Fernanda Silveira; Helen K Talbot; Richard Zimmerman; Emily R Smith; Manish Patel Journal: J Infect Dis Date: 2021-07-02 Impact factor: 5.226
Authors: Joshua D Doyle; Lauren Beacham; Emily T Martin; H Keipp Talbot; Arnold Monto; Manjusha Gaglani; Donald B Middleton; Fernanda P Silveira; Richard K Zimmerman; Elif Alyanak; Emily R Smith; Brendan L Flannery; Melissa Rolfes; Jill M Ferdinands Journal: Clin Infect Dis Date: 2021-03-15 Impact factor: 9.079