Journal
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
Volume 58, Issue 2, Pages 318-323Publisher
WILEY-BLACKWELL PUBLISHING, INC
DOI: 10.1111/j.1532-5415.2009.02667.x
Keywords
frailty index; deficit accumulation; comprehensive geriatric assessment; mobility; aging
Categories
Funding
- Seniors' Independence Research Program, through National Health Research and Development Program (NHRDP) [6606-3954-MC, 6603-1417-302]
- QEII Health Sciences Foundation
- Canadian Institutes of Health Research [MOP-62823]
Ask authors/readers for more resources
OBJECTIVES: To test the proposition, using routinely available clinical data, that deficit accumulation results in loss of redundancy. In keeping with the reliability theory of aging, this would be quantitated by attenuation in the slope of a Frailty Index (FI) with age. The more deficits, the less steep the slope and the less redundancy. DESIGN: Cross-sectional analysis of a prospective cohort study, with 5-year mortality data. SETTING: The clinical sample of the second wave of the Canadian Study of Health and Aging. PARTICIPANTS: Two thousand three hundred five people aged 70 and older at baseline. MEASUREMENTS: A FI based on data used for a Comprehensive Geriatric Assessment (CGA), the slope of the relationship between age and the FI-CGA, the limit value of the FI-CGA, mortality. RESULTS: An age-invariant limit to deficit accumulation was demonstrated; the observed 99% limit was 0.66. At the 25th percentile of deficit accumulation (FI-CGA similar to 0.18), the slope of the FI-CGA in relation to age was 0.044 (range 0.038-0.049). When deficits had increased to 75% of the maximum value (FI-CGA similar to 0.52), the slope fell to 0.021 (range 0.016-0.027). By the 85th percentile (FI-CGA similar to 0.6), the slope had become statistically indistinguishable from 0. CONCLUSION: As predicted by the reliability theory of aging, the rate of deficit accumulation slows with increasing frailty. A FI derived from data routinely collected as part of a CGA can in this way quantify loss of redundancy in older adults. Quantifying loss of redundancy can aid clinical decision-making; its application to individual prognostication in clinical samples warrants further evaluation. J Am Geriatr Soc 58:318-323, 2010.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available