The ability of three different models of frailty to predict all-cause mortality: Results from the European Male Aging Study (EMAS)
The ability of three different models of frailty to predict all-cause mortality: Results from the European Male Aging Study (EMAS)
复制标题
DOI：
10.1016/j.archger.2013.06.010
复制
发表时间：
2013-11-01
影响因子：
4
通讯作者：
O'Neill, Terence W.
中科院分区：
文献类型：
--
作者：
Ravindrarajah, Rathi;Lee, David M.;O'Neill, Terence W.
很少有研究直接比较最常用的衰弱模型预测社区居民死亡率的能力。在这里，我们使用衰弱指数 (FI)、衰弱表型 (FP) 和 FRAIL 量表 (FS) 来预测 EMAS 中的死亡率。参与者基线年龄为 40-79 岁 (n = 2929)，6.6% (n = 193) 在中位随访时间 4.3 年中死亡。 FI 由 39 项缺陷生成，包括自我报告的健康、发病、功能表现和心理评估。 FP 和 FS 由五个表型标准组成，当具有 0 个标准时，将个体归类为健壮，将 1-2 个标准归类为体弱，将 3+ 个标准归类为脆弱。平均 FI 随年龄线性增加 (r(2) = 0.21），在根据年龄、中心、吸烟和伴侣状况进行调整的 Cox 回归模型中，FI 每增加一个单位的死亡风险比 (HR) 为 1.49。根据 FP 或 FS 定义，处于体弱前或虚弱状态的男性与强壮的男性相比，死亡风险显着增加。与强壮男性相比，基线时 FP 虚弱的人的死亡 HR 为 3.84，而 FS 虚弱的人死亡 HR 为 3.87。在对潜在的混杂因素进行调整后，所有三个虚弱模型都显着预测了社区居住的中年和老年欧洲男性的未来死亡率。我们的数据表明，在预测未来死亡风险时，衰弱模型的选择可能并不是最重要的，因此可以灵活地使用方法。 (C) 2013 Elsevier Ireland Ltd. 保留所有权利。
Few studies have directly compared the ability of the most commonly used models of frailty to predict mortality among community-dwelling individuals. Here, we used a frailty index (FI), frailty phenotype (FP), and FRAIL scale (FS) to predict mortality in the EMAS. Participants were aged 40-79 years (n = 2929) at baseline and 6.6% (n = 193) died over a median 4.3 years of follow-up. The FI was generated from 39 deficits, including self-reported health, morbidities, functional performance and psychological assessments. The FP and FS consisted of five phenotypic criteria and both categorized individuals as robust when they had 0 criteria, prefrail as 1-2 criteria and frail as 3+ criteria. The mean FI increased linearly with age (r(2) = 0.21) and in Cox regression models adjusted for age, center, smoking and partner status the hazard ratio (HR) for death for each unit increase of the FI was 1.49. Men who were prefrail or frail by either the FP or FS definitions, had a significantly increased risk of death compared to their robust counterparts. Compared to robust men, those who were FP frail at baseline had a HR for death of 3.84, while those who were FS frail had a HR of 3.87. All three frailty models significantly predicted future mortality among community-dwelling, middle-aged and older European men after adjusting for potential confounders. Our data suggest that the choice of frailty model may not be of paramount importance when predicting future risk of death, enabling flexibility in the approach used. (C) 2013 Elsevier Ireland Ltd. All rights reserved.