ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2026
Updating and validating the Figueroa Frailty Index: transitioning from ICD-9 to ICD-10.
Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe Figueroa Frailty Index (Figueroa-FI) is a claims-based frailty index developed using administrative Medicare claims data using International Classification of Disease (ICD) 9th revision. Updating to ICD-10 codes is essential for contemporary measurement.
methodsICD-9 codes were mapped to ICD-10 using Centers for Medicaid and Medicare Services (CMS) General Equivalence Mappings. Using a national cohort of Veterans aged ≥65 years, 2012-2019, annual prevalence trends for the 12 Figueroa-FI deficits were examined. Validity of Figueroa-FI was ascertained by examining adjusted annual HR of death and long-term institutionalization (LTI) for Veterans with 1 and ≥2 deficits vs 0, using Cox proportional hazards models.
resultsAnnual cohorts of Veterans included 2.4 to 3.1 million Veterans, mean age 75 years, 97%-98% were male, 78%-80% White. Figueroa FI-ICD-10 includes 267 ICD-10 codes (vs 42 ICD-9 codes). Nine of the 12 Figueroa-FI deficits showed similar prevalence across the ICD-10 transition in 2016, while 3 displayed discontinuity. Veterans identified as frail were at increased risk of mortality and LTI. HR for death for FI of 1 vs 0 ranged from 1.97 to 2.02 over follow-up years, and HR of LTI from 2.75 to 2.92, while frail Veterans (FI ≥2) had hazards of death of 2.79 to 2.97 and hazards of LTI from 5.65 to 6.54.
conclusionsThe updated Figueroa FI-ICD-10 maintains content validity, stability, and predictive validity for mortality and LTI in a contemporary cohort of Veterans aged ≥65 years, enabling frailty measurement using ICD-10 claims for clinical and research use.
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