title: A frailty index based on laboratory deficits in community-dwelling men predicted their risk of adverse health outcomes.
abstract: abnormal laboratory test results accumulate with age and can be common in people with few clinically detectable health deficits. A frailty index (FI) based entirely on common physiological and laboratory tests (FI-Lab) might offer pragmatic and scientific advantages compared with a clinical FI (FI-Clin).
  
  
  
  to compare the FI-Lab with the FI-Clin and to assess their individual and combined relationships with mortality and other adverse health outcomes.
  
  
  
  secondary analysis of the eight-centre, longitudinal European Male Ageing Study (EMAS) of community-dwelling men aged 40-79 at baseline. Follow-up assessment occurred 4.4 ± 0.3 (mean ± SD) years later.
  
  
  
  we constructed a 23-item FI using common laboratory tests, blood pressure and pulse (FI-Lab), compared it with a previously validated 39-item FI using self-report and performance-based measures (FI-Clin) and finally combined both FIs to create a 62-item FI-Combined. Outcomes were all-cause mortality, institutionalisation, doctor visits, medication use, self-reported health, falls and fractures.
  
  
  
  the mean FI-Lab score was 0.28 ± 0.11, the FI-Clin was 0.13 ± 0.11 and FI-Combined was 0.19 ± 0.09. Age-adjusted models demonstrated that each FI was associated with mortality [HR (CI) FI-Lab: 1.04 (1.03-1.06); FI-Clin: 1.05 (1.04-1.06); FI-Combined: 1.07 (1.06-1.09)], institutionalisation, doctor visits, medication use, self-reported health and falls. Combined in a model with FI-Clin, the FI-Lab remained independently associated with mortality, institutionalisation, doctor visits, medication use and self-reported health.
  
  
  
  the FI-Lab detected an increased risk of adverse health outcomes alone and in combination with a clinical FI; further evaluation of the feasibility of the FI-Lab as a frailty screening tool within hospital care settings is needed.
authors.affiliation: Andrology Research Unit, University of Manchester, Manchester, UK Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Blodgett
authors.affiliation: Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Olga
authors.initials: O
authors.lastname: Theou
authors.affiliation: Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Howlett
authors.affiliation: Andrology Research Unit, Developmental and Regenerative Biomedicine Research Group, Manchester Academic Health Science Centre (MAHSC), The University of Manchester, Manchester, UK.
authors.forename: Frederick C W
authors.initials: FC
authors.lastname: Wu
authors.affiliation: Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Rockwood
mesh_terms: D000058:Accidental Falls; D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging; D001795:Blood Pressure Determination; D002423:Cause of Death; D005060:Europe / Q000453:epidemiology; D050723:Fractures, Bone / Q000175:diagnosis / Q000453:epidemiology; D016330:Frail Elderly; D000073496:Frailty / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D015577:Geriatric Assessment / Q000379:methods*; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D057187:Independent Living; D007326:Institutionalization; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D057566:Self Report; D012737:Sex Factors; D013997:Time Factors
keywords: ageing; frail older people; frailty; mortality; pre-clinical frailty