@article{ref1,
title="A Comparison of Frailty Indexes for the Prediction of Falls, Disability, Fractures, and Mortality in Older Men",
journal="Journal of the American Geriatrics Society",
year="2009",
author="Ensrud, Kristine E. and Ewing, Susan K. and Cawthon, Peggy M. and Fink, Howard A. and Taylor, Brent C. and Cauley, Jane A. and Dam, Thuy-Tien L. and Marshall, Lynn M. and Orwoll, Eric S. and Cummings, Steven R.",
volume="57",
number="3",
pages="492-498",
abstract="<p><b>OBJECTIVES: </b> To compare the validity of a parsimonious frailty index (components: weight loss, inability to rise from a chair, and poor energy (Study of Osteoporotic Fractures (SOF) index)) with that of the more complex Cardiovascular Health Study (CHS) index (components: unintentional weight loss, low grip strength, poor energy, slowness, and low physical activity) for prediction of adverse outcomes in older men.</p> <p><b>DESIGN: </b> Prospective cohort study.</p> <p><b>SETTING: </b> Six U.S. centers.</p> <p><b>PARTICIPANTS: </b> Three thousand one hundred thirty‐two men aged 67 and older.</p> <p><b>MEASUREMENTS: </b> Frailty status categorized as robust, intermediate stage, or frail using the SOF index and criteria similar to those used in CHS index. Falls were reported three times for 1 year. Disability (≥1 new impairments in performing instrumental activities of daily living) ascertained at 1 year. Fractures and deaths ascertained during 3 years of follow‐up. Analysis of area under the receiver operating characteristic curve (AUC) statistics compared for models containing the SOF index versus those containing the CHS index.</p> <p><b>RESULTS: </b> Greater evidence of frailty as defined by either index was associated with greater risk of adverse outcomes. Frail men had a higher age‐adjusted risk of recurrent falls (odds ratio (OR)=3.0–3.6), disability (OR=5.3–7.5), nonspine fracture (hazard ratio (HR)=2.2–2.3), and death (HR=2.5–3.5) (<i>P</i><.001 for all models). AUC comparisons revealed no differences between models with the SOF index and models with the CHS index in discriminating falls (AUC=0.63, <i>P</i>=.97), disability (AUC=0.68, <i>P</i>=.86), nonspine fracture (AUC=0.63, <i>P</i>=.90), or death (AUC=0.71 for model with SOF index and 0.72 for model with CHS index, <i>P</i>=.19).</p> <p><b>CONCLUSION: </b> The simple SOF index predicts risk of falls, disability, fracture, and mortality in men as well as the more‐complex CHS index.</p><p />",
language="",
issn="0002-8614",
doi="10.1111/j.1532-5415.2009.02137.x",
url="http://dx.doi.org/10.1111/j.1532-5415.2009.02137.x"
}