A New Operational Definition of Frailty: The Frailty Trait Scale |
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| Affiliation: | 1. Division of Geriatric Medicine, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Toledo, Spain;2. Inserm, CESP Centre for Research in Epidemiology and Population Health, Hormones and Cardiovascular Disease, University Paris Sud, Villejuif, France;3. Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain;4. Division of Geriatric Medicine, Hospital de Navarra, Pamplona, Spain;5. Division of Geriatric Medicine, Hospital Universitario de Getafe, Madrid, Spain;1. Gérontopôle, Department of Internal Medicine and Geriatrics, Toulouse University Hospital, Toulouse, France;2. INSERM UMR 1027, Paul Sabatier University Toulouse III, Toulouse, France;1. Department of Community Health and Epidemiology, Dalhousie University, Centre for Clinical Research, 5790 University Avenue, Halifax, Nova Scotia, Canada B3H 1V7;2. Geriatric Medicine, Department of Medicine, Dalhousie University, Veterans’ Memorial Building, 5955 Veterans’ Memorial Lane, Halifax, Nova Scotia, Canada;3. Centre for Health Care of the Elderly, QEII Health Sciences Centre, Capital District Health Authority, Veterans’ Memorial Building, 5955 Veterans’ Memorial Lane, Halifax, Nova Scotia, Canada;1. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong;2. Department of Medicine and Geriatrics, Shatin Hospital, Hospital Authority, Hong Kong;1. Department of Health Services Research, School CAPHRI, Maastricht University, Maastricht, The Netherlands;2. Department of Family Medicine, School CAPHRI, Maastricht University, Maastricht, The Netherlands;3. Department of Methodology and Statistics, School CAPHRI, Maastricht University, Maastricht, The Netherlands;4. Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, The Netherlands;5. Division of Geriatric Medicine, Saint Louis University, St Louis, MO;1. Department of Geriatrics, Hospital Universitario de Getafe and School of Health Sciences, Universidad Europea de Madrid, 28905 Getafe, Spain;2. Mailman School of Public Health and Columbia University Medical Center, New York, NY, USA |
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| Abstract: | ObjectivesTo provide a new instrument to diagnose frailty, the Frailty Trait Scale (FTS), that allows a more precise assessment and monitoring of individuals.DesignProspective population-based cohort study.SettingThe Toledo Study for Healthy Aging, Spain.ParticipantsA total of 1972 men and women aged 65 years or older.MeasurementsWe identified 7 frailty dimensions (energy balance–nutrition, physical activity, nervous system, vascular system, strength, endurance, and gait speed) represented by 12 items. Each item was pondered based on the quintiles of its distribution in the study population. Validity was evaluated by testing its association with factors related to frailty and its predictive value for adverse events. This predictive capacity was further compared with the capacity of 2 well-established frailty models (the frailty phenotype and the Frailty Index).ResultsFTS score was associated with several comorbidities and biomarkers classically associated with frailty. The FTS was associated with the incidence of hospitalization and mortality (hazard ratio associated with a score in the highest quartile [versus the first quartile] = 2.3, 95% confidence interval [CI] 1.6–3.4, and 2.5, 95% CI 1.8–3.6, respectively). Compared with Fried et al's definition, the FTS showed a better predictor for hospitalization in persons younger than 80 (area under the curve [AUC] = 0.65 vs 0.62, P = .01), and for mortality in the oldest group (AUC = 0.77 vs 0.72, P = .02). FTS showed similar predictive value to the Frailty Index.ConclusionFTS associates with many of the factors linked to frailty and has a similar predictive capacity to that provided by the classical instruments. Its characteristics offer some advantages over them, with potential utility in research and clinical practice. |
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| Keywords: | Weakness aging comorbidity sarcopenia lifestyle mortality frailty |
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