02154nas a2200181 4500008004100000022001400041245007600055210006900131260001600200520159700216100001701813700001501830700002301845700002301868700002001891700002501911856003601936 2019 eng d a1758-535X00aDiscrepancy in Frailty Identification: Move beyond Predictive Validity.0 aDiscrepancy in Frailty Identification Move beyond Predictive Val c2019 Feb 213 a

BACKGROUND: To evaluate the discordance in frailty classification between the frailty index (FI) and the physical frailty phenotype (PFP) and identify factors discriminating those with discordant frailty classification from each other and from those for whom the assessments agree.

METHODS: A prospective observational study of older adults aged 65 and older selected from Medicare eligibility lists in four US communities (n=5,362). The PFP was measured by the Cardiovascular Health Study PFP. Subjects meeting ≥3 of the 5 criteria were deemed frail. The FI was calculated as the proportion of deficits in an a priori selected set of 48 measures and subjects were classified as frail if FI>0.35.

RESULTS: The prevalence of frailty was 7.0% by the PFP and 8.3% by the FI. Of the 730 deemed frail by either instrument, only 12% were in agreement; whereas 39% were classified as frail by PFP but not FI; and 48% were classified as frail by FI but not PFP. Participants aged 65-72 or greater disease burden were mostly likely to be characterized as being FI-frail but not PFP-frail. The associations of frailty with age and mortality was stronger when frailty was measured by the PFP rather than the FI.

CONCLUSIONS: Despite comparable frailty prevalence between the PFP and the FI, there was substantial discordance in individual-level classification, with highest agreement existing only in the most vulnerable subset. These findings suggest that there are clinically important contexts in which PFP and FI cannot be used interchangeably.

1 aXue, Qian-Li1 aTian, Jing1 aWalston, Jeremy, D1 aChaves, Paulo, H M1 aNewman, Anne, B1 aBandeen-Roche, Karen uhttps://chs-nhlbi.org/node/7982