Cumulative Index of Health Deficiencies as a Characteristic of Long Life
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OBJECTIVES: To describe the accumulation of aging‐associated health disorders using a cumulative measure known as a frailty index (FI) and to evaluate its ability to differentiate long‐ and short‐life phenotypes as well as the FI's connection to aging‐associated processes in older people. DESIGN: Retrospective cross‐sectional and longitudinal studies. SETTING: The National Long‐Term Care Survey (NLTCS) data that assessed health and functioning of U.S. older individuals (≥65) in 1982, 1984, 1989, 1994, and 1999 were analyzed. The NLTCS sample in each survey represents a mixture of longitudinal and cross‐sectional components. PARTICIPANTS: Approximately 5,000 individuals in each survey. MEASUREMENTS: A cumulative index of health and well‐being deficiencies (disabilities, signs, diseases) was calculated as a count of deficits observed in an individual divided by the total number of all considered deficits. RESULTS: Men and women who died before the age of 75 and those who died after the age of 85 exhibited remarkably similar FI frequency patterns despite the 10‐year age difference between age profiles in these samples. Long life is consistently characterized in longitudinal analyses by lower FIs. FI dynamics are found to be strongly sex sensitive. CONCLUSION: The FI appears to be a sensitive age‐independent indicator of sex‐specific physiological decline in aging individuals and a sex‐specific discriminator of survival chances. The FI is a promising characteristic suitable for improving sex‐sensitive forecasts of risks of adverse health outcomes in older people.
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The results yielded by the frailty index have been consistent between surveys evaluated by our group and by others even though not every frailty index considers the same deficits or number of deficits.
“the results yielded by the frailty index have been consistent between surveys evaluated by our group [4-7] and by others [8-11] even though not every frailty index considers the same deficits, or even the same number of deficits.”
From A standard procedure for creating a frailty index (2008) · cites this paper as [9]
It does not matter if study A considered 40 deficits from set X and study B considered 60 deficits from set Y; the estimates from each (e.g. rate of deficit accumulation, relationship with mortality, limit) appear to be similar.
“it does not matter if study A considered 40 deficits from set X of deficits and study B considered 60 deficits from set Y of deficits; the estimates from each (e.g. the rate of deficit accumulation, the relationship between deficit accumulation and mortality, or the limit to deficit accumulation) appear to be similar.”
From A standard procedure for creating a frailty index (2008) · cites this paper as [9]
Cites
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“For instance, the shape parameters (skewness and kurtosis) can distinguish between healthy and unhealthy phenotypes.(25,27) To assess the FI’s prognostic power to differentiate long- and short-life phenotypes, two types of longitudinal analyses were performed.”
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Feature Selection Algorithms Enhance the Accuracy of Frailty Indexes as Measures of Biological Age
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The Evolution of Health over the Life Cycle
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Studying health histories of cancer: A new model connecting cancer incidence and survival
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Self-citationProcrastination and preventive health-care in the older U.S. population
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Generating synthetic aging trajectories with a weighted network model using cross-sectional dataPreprint
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Self-citationPreditores do envelhecimento saudável: fatores epigenéticos e o gene APOE
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How important is health inequality for lifetime earnings inequality?
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- Authors
- Kulminski, A. M., Ukraintseva, S. V., Akushevich, I. V., Arbeev, K. G., & Yashin, A. I.
- Affiliations
- Duke University (US)
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2007-04-11
- Volume
- 55
- Issue
- 6
- Pages
- 935-940
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC1893090
- OpenAlex
- W1524886961
- Cited by
- 96
- References
- 30
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 3 · 2022: 3 · 2021: 6 · 2020: 5 · 2019: 5 · 2018: 5 · 2017: 2 · 2016: 8 · 2015: 2 · 2014: 6 · 2013: 5 · 2012: 8
- FWCI
- 4.17
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (P01AG008761, R01AG027019, R01AG028259, U01AG007198)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- frailty index, longevity, aging, health deficits, sex differences, mortality, older adults, disability, National Long Term Care Survey
- MeSH terms
- Aged, Aged, 80 and over, Aging, Cross-Sectional Studies, Female, Health Status Indicators, Health Surveys, Humans, Longevity, Longitudinal Studies, Male, Retrospective Studies, Sex Factors, United States, Frail Elderly
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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