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The ability of four frailty screening instruments to predict mortality, hospitalization and dependency in (instrumental) activities of daily living

Author

Listed:
  • Linda P. M. Op het Veld

    (Zuyd University of Applied Sciences
    Maastricht University)

  • Anna J. H. M. Beurskens

    (Zuyd University of Applied Sciences
    Maastricht University)

  • Henrica C. W. Vet

    (Amsterdam University Medical Centers, location VU University)

  • Sander M. J. Kuijk

    (Maastricht University Medical Centre)

  • KlaasJan Hajema

    (Academic Collaborative Centres Public Health (ACC))

  • Gertrudis I. J. M. Kempen

    (Maastricht University)

  • Erik Rossum

    (Zuyd University of Applied Sciences
    Maastricht University)

Abstract

The aim of this study was to assess the predictive ability of the frailty phenotype (FP), Groningen Frailty Indicator (GFI), Tilburg Frailty Indicator (TFI) and frailty index (FI) for the outcomes mortality, hospitalization and increase in dependency in (instrumental) activities of daily living ((I)ADL) among older persons. This prospective cohort study with 2-year follow-up included 2420 Dutch community-dwelling older people (65+, mean age 76.3 ± 6.6 years, 39.5% male) who were pre-frail or frail according to the FP. Mortality data were obtained from Statistics Netherlands. All other data were self-reported. Area under the receiver operating characteristic curves (AUC) was calculated for each frailty instrument and outcome measure. The prevalence of frailty, sensitivity and specificity were calculated using cutoff values proposed by the developers and cutoff values one above and one below the proposed ones (0.05 for FI). All frailty instruments poorly predicted mortality, hospitalization and (I)ADL dependency (AUCs between 0.62–0.65, 0.59–0.63 and 0.60–0.64, respectively). Prevalence estimates of frailty in this population varied between 22.2% (FP) and 64.8% (TFI). The FP and FI showed higher levels of specificity, whereas sensitivity was higher for the GFI and TFI. Using a different cutoff point considerably changed the prevalence, sensitivity and specificity. In conclusion, the predictive ability of the FP, GFI, TFI and FI was poor for all outcomes in a population of pre-frail and frail community-dwelling older people. The FP and the FI showed higher values of specificity, whereas sensitivity was higher for the GFI and TFI.

Suggested Citation

  • Linda P. M. Op het Veld & Anna J. H. M. Beurskens & Henrica C. W. Vet & Sander M. J. Kuijk & KlaasJan Hajema & Gertrudis I. J. M. Kempen & Erik Rossum, 2019. "The ability of four frailty screening instruments to predict mortality, hospitalization and dependency in (instrumental) activities of daily living," European Journal of Ageing, Springer, vol. 16(3), pages 387-394, September.
    • Handle: RePEc:spr:eujoag:v:16:y:2019:i:3:d:10.1007_s10433-019-00502-4
    DOI: 10.1007/s10433-019-00502-4
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    References listed on IDEAS

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    1. Kempen, G. I. J. M. & Miedema, I. & Ormel, J. & Molenaar, W., 1996. "The assessment of disability with the Groningen Activity Restriction Scale. Conceptual framework and psychometric properties," Social Science & Medicine, Elsevier, vol. 43(11), pages 1601-1610, December.
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    Cited by:

    1. Lotte Vestjens & Jane Murray Cramm & Anna Petra Nieboer, 2021. "A cross-sectional study investigating the relationships between self-management abilities, productive patient-professional interactions, and well-being of community-dwelling frail older people," European Journal of Ageing, Springer, vol. 18(3), pages 427-437, September.

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