ArticleJournal of the American Geriatrics Society2020
Changes in Predictive Performance of a Frailty Index with Availability of Clinical Domains.
Article in Journal of the American Geriatrics Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers.
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Who cites it
39 citing papers in PubMed.
- Feasibility of a Multicomponent Frailty Intervention During Post-Acute Rehabilitation in Skilled Nursing Facilities.Journal of the American Geriatrics Society · 2026Article
- Differences in the Measurement of Comorbidities Based on ICD-10-CM Coding Definitions Using Medicare Advantage Encounter Data and Fee-For-Service Claims.Medical care · 2026Article
- Does the frailty index applied to randomised controlled trials really measure frailty?Age and ageing · 2025Article
- Associations of frailty with survival, hospitalization, functional decline, and toxicity among older adults with advanced non-small cell lung cancer.The oncologist · 2025Article
- Frailty and physical activity: are all physical activity variables equal?The journals of gerontology. Series A, Biological sciences and medical sciences · 2025Article
- Explainable machine learning framework for biomarker discovery by combining biological age and frailty prediction.Scientific reports · 2025Article
- Article
- Health Care Spending After Initiating Sacubitril-Valsartan vs Renin-Angiotensin System Blockers for Heart Failure Treatment.JAMA health forum · 2025Article
- Association of Frailty Index at 66 Years of Age with Health Care Costs and Utilization Over 10 Years in Korea: Retrospective Cohort Study.JMIR public health and surveillance · 2025Article
- Extracting Cognitive Impairment Assessment Information From Unstructured Notes in Electronic Health Records Using Natural Language Processing Tools: Validation with Clinical Assessment Data.Clinical epidemiology · 2025Article
- Unleashing frailty from laboratory into real world: A critical step toward frailty-guided clinical care of older adults.Journal of the American Geriatrics Society · 2024Article
- Prevalence and future estimates of frailty and pre-frailty in a population-based sample of people 70 years and older in Norway: the HUNT study.Aging clinical and experimental research · 2024Article
- Frailty in Older Adults.The New England journal of medicine · 2024Review
- Frailty in Medicare Advantage Beneficiaries and Traditional Medicare Beneficiaries.JAMA network open · 2024Article
- Usefulness of the Clinical Frailty Scale in patients with end-stage kidney disease.Clinical kidney journal · 2024Article
- Assessing the Benefits and Harms of Pharmacotherapy in Older Adults with Frailty: Insights from Pharmacoepidemiologic Studies of Routine Health Care Data.Drugs & aging · 2024Review
- New horizons in frailty identification via electronic frailty indices: early implementation lessons from experiences in England and the United States.Age and ageing · 2024Article
- Association of preoperative frailty with the risk of postoperative delirium in older patients undergoing hip fracture surgery: a prospective cohort study.Aging clinical and experimental research · 2024Article
- How to construct a frailty index from an existing dataset in 10 steps.Age and ageing · 2023Article
- Construct validity of the electronic Veterans Affairs Frailty Index against clinician frailty assessment.Journal of the American Geriatrics Society · 2023Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
objectivesDetermine the effects of missing data in frailty identification and risk prediction.
designAnalysis of the National Health in Aging Trends Study.
settingCommunity.
participantsAbout 6206 older adults. MEASUREMENTS: A 41-variable frailty index (FI) was constructed with the following domains: comorbidities, activities of daily living (ADLs), instrumental activities of daily living, self-reported physical limitations, physical performance, and neuropsychiatric tests. We evaluated discrimination after removing single and multiple domains, comparing C-statistics for predicting 5-year risk of mortality and 1-year risks of disability and falls.
resultsThe full FI yielded a mean of .18 and C-statistics of .72 (95% confidence interval, .70-.74) for mortality, .80 (.77-.82) for disability, and .66 (.64-.68) for falls. Removal of any single domain shifted the FI distribution, resulting in a mean FI ranging from .13 (removing comorbidities) to .20 (removing ADLs) and frailty prevalence (FI ≥ .25) from 16.0% to 28.7%. Among robust participants models missing ADLs misclassified most often, (19% as pre-frail). Among pre-frail and frail participants missing comorbidities misclassified most often(69.2% from pre-frail to robust, 24% from frail to pre-frail, and 4.9% from frail to robust). Removal of any single domain minimally changed C-statistics: mortality, .71-.73; disability, .79-.80; and falls, .64-.66. Removing neuropsychiatric testing and physical performance yielded comparable C-statistics of .70, .78, and .66 for mortality, ADLs, and falls, respectively. However, removal of three or four domains based on likely availability decreased C-statistics for mortality (.69, .66),disability (.75, .70), and falls (.64, .63), respectively.
conclusionWhile FI discrimination is robust to missing information in any single domain, risk prediction is affected by absence of multiple domains. This work informs the application of FI as a clinical and research tool. J Am Geriatr Soc 68:1771-1777, 2020.
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