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Assessing Global Frailty Scores: Development of a Global Burden of Disease-Frailty Index (GBD-FI)

Author

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  • Mark O’Donovan

    (College of Medicine, Nursing and Health Sciences, National University of Ireland, H91 TK33 Galway, Ireland
    HRB Clinical Research Facility Cork, Mercy University Hospital Cork, T12 WE28 Cork City, Ireland)

  • Duygu Sezgin

    (College of Medicine, Nursing and Health Sciences, National University of Ireland, H91 TK33 Galway, Ireland)

  • Zubair Kabir

    (School of Public Health, University College Cork, T12 XF62 Cork City, Ireland)

  • Aaron Liew

    (College of Medicine, Nursing and Health Sciences, National University of Ireland, H91 TK33 Galway, Ireland
    Department of Endocrinology, Portiuncula University Hospital, Ballinasloe, H53 T971 Country Galway, Ireland)

  • Rónán O’Caoimh

    (College of Medicine, Nursing and Health Sciences, National University of Ireland, H91 TK33 Galway, Ireland
    Department of Geriatric Medicine, Mercy University Hospital Cork, T12 WE28 Cork City, Ireland)

Abstract

Frailty is an independent age-associated predictor of morbidity and mortality. Despite this, many countries lack population estimates with large heterogeneity between studies. No population-based standardised metric for frailty is available. We applied the deficit accumulation model of frailty to create a frailty index (FI) using population-level estimates from the Global Burden of Disease (GBD) 2017 study across 195 countries to create a novel GBD frailty index (GBD-FI). Standard FI criteria were applied to all GBD categories to select GBD-FI items. Content validity was assessed by comparing the GBD-FI with a selection of established FIs. Properties including the rate of deficit accumulation with age were examined to assess construct validity. Linear regression models were created to assess if mean GBD-FI scores predicted one-year incident mortality. From all 554 GBD items, 36 were selected for the GBD-FI. Face validity against established FIs was variable. Characteristic properties of a FI—higher mean score for females and a deficit accumulation rate of approximately 0.03 per year, were observed. GBD-FI items were responsible for 19% of total Disability-Adjusted Life Years for those aged ≥70 years in 2017. Country-specific mean GBD-FI scores ranged from 0.14 (China) to 0.19 (Hungary) and were a better predictor of mortality from non-communicable diseases than age, gender, Healthcare Access and Quality Index or Socio-Demographic Index scores. The GBD-FI is a valid measure of frailty at population-level but further external validation is required.

Suggested Citation

  • Mark O’Donovan & Duygu Sezgin & Zubair Kabir & Aaron Liew & Rónán O’Caoimh, 2020. "Assessing Global Frailty Scores: Development of a Global Burden of Disease-Frailty Index (GBD-FI)," IJERPH, MDPI, vol. 17(16), pages 1-17, August.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:16:p:5695-:d:395580
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    References listed on IDEAS

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    1. Giuseppe Liotta & Silvia Ussai & Maddalena Illario & Rónán O’Caoimh & Antonio Cano & Carol Holland & Regina Roller-Winsberger & Alessandra Capanna & Chiara Grecuccio & Mariacarmela Ferraro & Francesca, 2018. "Frailty as the Future Core Business of Public Health: Report of the Activities of the A3 Action Group of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA)," IJERPH, MDPI, vol. 15(12), pages 1-26, December.
    2. Yao-Chun Wen & Liang-Kung Chen & Fei-Yuan Hsiao, 2017. "Predicting mortality and hospitalization of older adults by the multimorbidity frailty index," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-10, November.
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