Agreement Between 35 Published Frailty Scores in the General Population.
In elderly populations, frailty is associated with higher mortality risk. Although many frailty scores (FS) have been proposed, no single score is considered the gold standard. We aimed to evaluate the agreement between a wide range of FS in the English Longitudinal Study of Ageing (ELSA). Through a literature search, we identified 35 FS that could be calculated in ELSA wave 2 (2004-2005). We examined agreement between each frailty score and the mean of 35 FS, using a modified Bland-Altman model and Cohen's kappa (κ). Missing data were imputed. Data from 5,377 participants (ages ≥60 years) were analyzed (44.7% men, 55.3% women). FS showed widely differing degrees of agreement with the mean of all scores and between each pair of scores. Frailty classification also showed a very wide range of agreement (Cohen's κ = 0.10-0.83). Agreement was highest among "accumulation of deficits"-type FS, while accuracy was highest for multidimensional FS. There is marked heterogeneity in the degree to which various FS estimate frailty and in the identification of particular individuals as frail. Different FS are based on different concepts of frailty, and most pairs cannot be assumed to be interchangeable. Research results based on different FS cannot be compared or pooled.
['Aguayo|Gloria A|GA|', 'Donneau|Anne-Françoise|AF|', 'Vaillant|Michel T|MT|', 'Schritz|Anna|A|', 'Franco|Oscar H|OH|', 'Stranges|Saverio|S|', 'Malisoux|Laurent|L|', 'Guillaume|Michèle|M|', 'Witte|Daniel R|DR|']
D000368:Aged D000369:Aged, 80 and over D000375:Aging D015992:Body Mass Index D002908:Chronic Disease D003071:Cognition D015897:Comorbidity D004739:England D015444:Exercise D005260:Female D016330:Frail Elderly D015577:Geriatric Assessment D006801:Humans D008137:Longitudinal Studies D008297:Male D017533:Marital Status D008875:Middle Aged D010641:Phenotype D012015:Reference Standards D012907:Smoking
agreement frailty scores elderly population Bland-Altman model accuracy Cohen's kappa coefficient disability reliability