Multidimensional Frailty Predicts Mortality Better than Physical Frailty in Community-Dwelling Older People: A Five-Year Longitudinal Cohort Study

Alberto Cella, Nicola Veronese, Monica Pomata, Katerin Leslie Quispe Guerrero, Clarissa Musacchio, Barbara Senesi, Camilla Prete, Erica Tavella, Ekaterini Zigoura, Giacomo Siri and Alberto Pilotto
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Alberto Cella: Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, 16128 Genova, Italy
Nicola Veronese: Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, 16128 Genova, Italy
Monica Pomata: Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, 16128 Genova, Italy
Katerin Leslie Quispe Guerrero: Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, 16128 Genova, Italy
Clarissa Musacchio: Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, 16128 Genova, Italy
Barbara Senesi: Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, 16128 Genova, Italy
Camilla Prete: Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, 16128 Genova, Italy
Erica Tavella: Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, 16128 Genova, Italy
Ekaterini Zigoura: Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, 16128 Genova, Italy
Giacomo Siri: Scientific Directorate Biostatistics, Galliera Hospital, 16128 Genova, Italy
Alberto Pilotto: Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, 16128 Genova, Italy

IJERPH, 2021, vol. 18, issue 23, 1-7

Abstract: Frailty is a common syndrome in older people that carries an increased risk of mortality. Two main models describe frailty, either as a loss of physical functions or as an accumulation of multiple deficits. The aim of our study was to compare the physical frailty index developed in the Cardiovascular Health Study (CHS) with a multidimensional frailty tool, the Multidimensional Prognostic Index (MPI), in predicting death in community-dwelling older subjects. Four hundred and seven community-dwelling older subjects were enrolled. Each subject underwent a comprehensive geriatric assessment (CGA) with calculation of the MPI and CHS index. Mortality was recorded over the following 5 years. In the overall sample (mean age of 77.9 ± 4.5 years; 51.6% female), 53 subjects (13%) died during the 5-year follow-up period. Both the MPI and CHS index were able to predict mortality; however, the MPI was significantly more accurate than the CHS index in predicting mortality (C-index = 0.69 and 0.59, respectively; p < 0.001), with a statistically significant difference of 10%. In conclusion, multidimensional frailty, assessed by the MPI, predicts five-year mortality in community-dwelling older people better than physical frailty, as assessed by the CHS index. These findings suggest the usefulness of assessing frailty by means of CGA-based tools to predict relevant health-negative outcomes in older people.

Keywords: frailty; multidimensional prognostic index; prognosis; mortality (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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