Mark Q Thompson1,2, Olga Theou1,3, Graeme R Tucker1, Robert J Adams4,5, Renuka Visvanathan1,2,6. 1. National Health and Medical Research Council (NHMRC) Centre of Research Excellence: Frailty and Healthy Ageing, University of Adelaide, Adelaide, South Australia, Australia. 2. Faculty of Health and Medical Sciences, Adelaide Geriatrics Training & Research with Aged Care (G-TRAC) Centre, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia. 3. Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. 4. Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University of South Australia, Adelaide, South Australia, Australia. 5. Respiratory and Sleep Services, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia. 6. Aged and Extended Care Services, Central Adelaide Local Health Network, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
Abstract
OBJECTIVE: To examine the predictive validity of the FRAIL scale for mortality, and diagnostic test accuracy (DTA) against the frailty phenotype (FP). MEASUREMENT: Frailty was measured in 846 community-dwelling adults (mean age 74.3 [SD 6.3] years, 54.8% female) using a modified FRAIL scale and modified FP. Mortality was matched to death records. RESULTS: The FRAIL scale demonstrated significant predictive validity for mortality up to 10 years (Frail adjHR: 2.60, P < .001). DTA findings were acceptable for specificity (86.8%) and Youden index (0.50), but not sensitivity (63.6%), or area under the receiver operator curve (auROC) (0.75). DTA estimates were more acceptable when a cut-point of ≥2 characteristics was used rather than ≥3 in the primary DTA analysis. CONCLUSION: The FRAIL scale is a valid predictor of mortality. DTA estimates depend on FRAIL scale cut-point used. This instrument is a potentially useful frailty screening tool.
OBJECTIVE: To examine the predictive validity of the FRAIL scale for mortality, and diagnostic test accuracy (DTA) against the frailty phenotype (FP). MEASUREMENT: Frailty was measured in 846 community-dwelling adults (mean age 74.3 [SD 6.3] years, 54.8% female) using a modified FRAIL scale and modified FP. Mortality was matched to death records. RESULTS: The FRAIL scale demonstrated significant predictive validity for mortality up to 10 years (Frail adjHR: 2.60, P < .001). DTA findings were acceptable for specificity (86.8%) and Youden index (0.50), but not sensitivity (63.6%), or area under the receiver operator curve (auROC) (0.75). DTA estimates were more acceptable when a cut-point of ≥2 characteristics was used rather than ≥3 in the primary DTA analysis. CONCLUSION: The FRAIL scale is a valid predictor of mortality. DTA estimates depend on FRAIL scale cut-point used. This instrument is a potentially useful frailty screening tool.
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