title: Validation and comparison of two frailty indexes: The MOBILIZE Boston Study.
abstract: OBJECTIVE
  To validate two established frailty indexes and compare their ability to predict adverse outcomes in a diverse, elderly, community-dwelling sample of men and women.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  A diverse defined geographic area of Boston.
  
  
  METHODS
  Seven hundred sixty-five community-dwelling participants in the Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly Boston Study.
  
  
  METHODS
  Two published frailty indexes, recurrent falls, disability, overnight hospitalization, emergency department (ED) visits, chronic medical conditions, self-reported health, physical function, cognitive ability (including executive function), and depression. One index was developed from the Study of Osteoporotic Fractures (SOF) and the other from the Cardiovascular Health Study (CHS).
  
  
  RESULTS
  The SOF frailty index classified 77.1% as robust, 18.7% as prefrail, and 4.2% as frail. The CHS frailty index classified 51.2% as robust, 38.8% as prefrail, and 10.0% as frail. Both frailty indexes (SOF; CHS) were similar in their ability to predict key geriatric outcomes such as recurrent falls (hazard ratio (HR)(frail)=2.2, 95% confidence interval (CI)=1.2-4.0; HR(frail)=1.9, 95% CI=1.2-3.1), overnight hospitalization (odds ratio (OR)(frail)=3.5, 95% CI=1.5-8.0; OR(frail)=4.4, 95% CI=2.4-8.2), ED visits (OR(frail)=3.5, 95% CI=1.4,8.8; OR(frail)=3.1, 95% CI=1.6-5.9), and disability (OR(frail)=5.4, 95% CI=2.3-12.3; OR(frail)=7.7, 95% CI=4.0-14.7), as well as chronic medical conditions, physical function, cognitive ability, and depression.
  
  
  CONCLUSIONS
  Two established frailty indexes were validated using an independent elderly sample of diverse men and women; both indexes were good at distinguishing geriatric conditions and predicting recurrent falls, overnight hospitalization, and ED visits according to level of frailty. Although both indexes are good measures of frailty, the simpler SOF index may be easier and more practical in a clinical setting.
authors.affiliation: Institute for Aging Research, Hebrew SeniorLife, 1200 Centre St, Boston, MA 02131, USA. kiely@hrca.harvard.edu
authors.forename: Dan K
authors.initials: DK
authors.lastname: Kiely
authors.forename: L Adrienne
authors.initials: LA
authors.lastname: Cupples
authors.forename: Lewis A
authors.initials: LA
authors.lastname: Lipsitz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001900:Boston; D002908:Chronic Disease / Q000453:epidemiology; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D057187:Independent Living; D007360:Intelligence; D008297:Male; D009042:Motivation; D004856:Postural Balance; D015203:Reproducibility of Results
references.citation: JAMA. 1963 Sep 21;185:914-9
references.pmid: 14044222
references.citation: Arch Intern Med. 2008 Feb 25;168(4):382-9
references.pmid: 18299493
references.citation: Gerontologist. 1969 Autumn;9(3):179-86
references.pmid: 5349366
references.citation: J Gerontol A Biol Sci Med Sci. 2004 Mar;59(3):255-63
references.pmid: 15031310
references.citation: Am J Med. 2005 Nov;118(11):1225-31
references.pmid: 16271906
references.citation: J Gerontol. 1994 Mar;49(2):M85-94
references.pmid: 8126356
references.citation: J Neurol Neurosurg Psychiatry. 1998 May;64(5):588-94
references.pmid: 9598672
references.citation: J Gerontol A Biol Sci Med Sci. 2006 Mar;61(3):262-6
references.pmid: 16567375
references.citation: J Am Geriatr Soc. 2005 Aug;53(8):1321-30
references.pmid: 16078957
references.citation: J Psychiatr Res. 1982-1983;17(1):37-49
references.pmid: 7183759
references.citation: J Am Geriatr Soc. 2003 Oct;51(10):1439-44
references.pmid: 14511165
references.citation: J Am Geriatr Soc. 2008 Sep;56(9):1744-9
references.pmid: 18662198
references.citation: N Engl J Med. 1995 Mar 2;332(9):556-61
references.pmid: 7838189
references.citation: J Gerontol A Biol Sci Med Sci. 2000 Apr;55(4):M221-31
references.pmid: 10811152
references.citation: Int J Geriatr Psychiatry. 2000 Jun;15(6):548-61
references.pmid: 10861923
references.citation: J Gerontol B Psychol Sci Soc Sci. 1999 Sep;54(5):P328-33
references.pmid: 10542825
references.citation: J Gerontol A Biol Sci Med Sci. 2007 Jul;62(7):744-51
references.pmid: 17634322
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: J Clin Neuropsychol. 1981 May;3(1):53-63
references.pmid: 7276196
references.citation: Clin Neuropsychol. 1999 Aug;13(3):348-58
references.pmid: 10726605
references.citation: BMC Geriatr. 2008 Jul 18;8:16
references.pmid: 18638389
references.citation: J Clin Epidemiol. 1993 Feb;46(2):153-62
references.pmid: 8437031
references.citation: Aging Clin Exp Res. 2005 Dec;17(6):465-71
references.pmid: 16485864
references.citation: J Neurol Sci. 1969 Jul-Aug;9(1):39-48
references.pmid: 5820858
references.citation: J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56
references.pmid: 11253156
references.citation: J Am Geriatr Soc. 2007 Aug;55(8):1216-23
references.pmid: 17661960
references.citation: Neuropsychologia. 1974 Jul;12(3):323-30
references.pmid: 4421777
references.citation: Am J Epidemiol. 1986 Sep;124(3):372-88
references.pmid: 3740038