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A Comparison of Frailty Indexes for the Prediction of Falls, Disability, Fractures, and Mortality in Older Men
Open accessAbstract
OBJECTIVES: 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. DESIGN: Prospective cohort study. SETTING: Six U.S. centers. PARTICIPANTS: Three thousand one hundred thirty‐two men aged 67 and older. MEASUREMENTS: 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. RESULTS: 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) ( P <.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, P =.97), disability (AUC=0.68, P =.86), nonspine fracture (AUC=0.63, P =.90), or death (AUC=0.71 for model with SOF index and 0.72 for model with CHS index, P =.19). CONCLUSION: The simple SOF index predicts risk of falls, disability, fracture, and mortality in men as well as the more‐complex CHS index.
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“Obesity is inversely related to BMD and fractures313 but might increase the fracture risk through bone quality314,315 or frailty132,316 independent of BMD.”
From Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies (2018) · cites this paper as [316]
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Dietary Problems Are Associated with Frailty Status in Older People with Fewer Teeth in Japan
Miyano, T., Kaneko, R., KIMURA, T., Maruoka, M., Kishimura, A., Kato, K., Furuta, M., & Yamashita, Y. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192316260 · Cited by 11
“The SOF index has been reported to be simpler and more comparable to the CHS index [21].”
MethodTsutsumimoto, K., Doi, T., Shimada, H., Makizako, H., Uemura, K., Ando, H., & Suzuki, T. (2014) · Journal of Physical Therapy Science · doi:10.1589/jpts.26.1979 · Cited by 11
Wang, Y.-R., Lee, H., Hsieh, P., Chang, C.-H., & Chen, C. (2023) · BMC Nursing · doi:10.1186/s12912-023-01481-9 · Cited by 10
“It was used to predict falls, disability, fractures, and mortality-related comorbidities [24, 25 [20] then translated it into the Chinese version in accordance with the process of translation and adaptation of instruments [28].”
Lin, T.-C., Lu, Y., Chao, C., Lin, S.-J., Wu, P.-S., Chan, D., & Lee, H. (2024) · Journal of the Formosan Medical Association · doi:10.1016/j.jfma.2024.10.023 · Cited by 10
Dzando, G., Ward, P., Asante, D., & Ambagtsheer, R. C. (2024) · Ageing Research Reviews · doi:10.1016/j.arr.2024.102571 · Cited by 11
Identifying and Estimating Frailty Phenotypes by Vocal Biomarkers: Cross-Sectional Study
Lin, Y., Yan, H., Lin, C.-H., & Chang, H. (2024) · Journal of Medical Internet Research · doi:10.2196/58466 · Cited by 10
PHYSICAL ACTIVITY LEVEL, FUNCTIONAL MOBILITY AND FALL RISK IN THE ELDERLY
da Silva, R. A., Brandão, G. S., da Silva, A. S., Urbano, J. J., Oliveira, E. F., de Oliveira, L. V. F., Camelier, A. A., & Brandão, G. S. (2017) · Manual Therapy Posturology & Rehabilitation Journal · doi:10.17784/mtprehabjournal.2017.15.479 · Cited by 10
“(23,28) The natural aging process causes structural and functional deterioration, generating alterations in the psychomotor function and balance, predisposing to falls.(29) The risk of falls in the elderly may be evaluated by performing the TUG test, and an adequate test performance may be indicative of good functiona…”
BackgroundContrast sensitivity is associated with frailty
Amir, N. N., Kamaruzzaman, S. B., Effendi-Tenang, I., Jamaluddin, M., Tan, M. P., Ramli, N. M., Khaliddin, N., & Zahari, M. B. (2021) · European Geriatric Medicine · doi:10.1007/s41999-021-00450-2 · Cited by 10
Sato, H., Yano, A., Shimoyama, Y., Sato, T., Sugiyama, Y., & Kishi, M. (2021) · BMC Oral Health · doi:10.1186/s12903-021-01926-0 · Cited by 10
Conceptualizing Biological Aging and Frailty in Orthopaedics
Cong, T., Hall, A. J., Jia, Z., Christiano, A. V., Elsevier, H. C. K., Cheung, Z. B., Wellman, D. S., Forsh, D., & Lane, J. M. (2022) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.21.01053 · Cited by 10
Chou, C.-P., Chen, K., Tung, H., Belcastro, F. P., & Hsu, H. (2022) · Experimental Gerontology · doi:10.1016/j.exger.2022.111799 · Cited by 10
Role of Muscle Ultrasound for the Study of Frailty in Elderly Patients with Diabetes: A Pilot Study
Simó-Servat, A., Guevara, E., Perea, V., Alonso-Carril, N., Quirós, C., Puig-Jové, C., & Barahona, M. J. (2023) · Biology · doi:10.3390/biology12060884 · Cited by 12
Prospective GERiatric Observational (ProGERO) study: cohort design and preliminary results
Saraiva, M. D., Rangel, L. F., Cunha, J. L. L., Rotta, T. C. A., Douradinho, C., Khazaal, E. J. B., Aliberti, M. J. R., Avelino‐Silva, T. J., Apolinário, D., Suemoto, C. K., et al. (2020) · BMC Geriatrics · doi:10.1186/s12877-020-01820-4 · Cited by 10
“Detailed instructions to administer the SOF and FRAIL indexes can be found in the assessment form in the Supplementary Material.”
BackgroundMethodInfluentialA Fall Detector Based on Ultra-Wideband Radar Sensing
Diraco, G., Leone, A., & Siciliano, P. A. (2017) · Lecture notes in electrical engineering · doi:10.1007/978-3-319-55077-0_47 · Cited by 10
Forecasting Postoperative Delirium in Older Adult Patients with Fast-and-Frugal Decision Trees
Heinrich, M., Woike, J. K., Spies, C., & Wegwarth, O. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11195629 · Cited by 9
Ko, C., Chao, C.-L., Hung, C., Du, J., & Feng, M. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm14010062 · Cited by 9
“Men with none of these components are classified as robust, whereas those with one component are considered in an intermediate stage of frailty [38].”
Developing physical frailty specifications for investigation of frailty pathways in older people
Ding, Y. Y. (2016) · AGE · doi:10.1007/s11357-016-9903-4 · Cited by 9
A community-based cross-sectional survey of orthostatic hypotension among elderly from south India
Sasidharan, A., & Ambatipudi, S. (2022) · Indian Heart Journal · doi:10.1016/j.ihj.2022.11.007 · Cited by 9
Self‐reported exhaustion associated with physical activity among older adults
Tsutsumimoto, K., Doi, T., Shimada, H., Makizako, H., Yoshida, D., Uemura, K., Anan, Y., Park, H., & Suzuki, T. (2015) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/ggi.12528 · Cited by 9
Iriarte, E., & Araya, A.-X. (2016) · Revista médica de Chile · doi:10.4067/s0034-98872016001100010 · Cited by 9
“J Gerontol A Biol Sci Med Sci 2004; 59 (3): 25563.”
The Predictability of Frailty Associated with Musculoskeletal Deficits: A Longitudinal Study
Tembo, M. C., Mohebbi, M., Holloway‐Kew, K. L., Gaston, J., Brennan-Olsen, S. L., Williams, L. J., Kotowicz, M. A., & Pasco, J. A. (2021) · Calcified Tissue International · doi:10.1007/s00223-021-00865-w · Cited by 9
“Indeed, frailty assessment tools have incorporated musculoskeletal components to varying degrees [4, 39, 40].”
BackgroundSong, C., Tsauo, J., Fang, P.-H., Fang, I.-Y., & Chang, S.-H. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18147243 · Cited by 9
“Eligible participants meeting the following inclusion criteria: aged ≥65 years old, ambulant, pre-frail or frail (defined by SOF frailty index [22]) or had history of falls in the past year, and absence of dementia were identified by 12 district health centers of Taipei City, and were invited to participate.”
BackgroundPredicting frailty in older adults using vocal biomarkers: a cross-sectional study
Lin, Y., Yan, H., Lin, C., & Chang, H. (2022) · BMC Geriatrics · doi:10.1186/s12877-022-03237-7 · Cited by 9
“Furthermore, a simple frailty index with three components has been proposed based on the predictive validity of each component and its suitability for component assessment in clinical practice (Study of Osteoporotic Fractures [SOF] index) [8].”
MethodThe Validity and Reliability of the Kaigo-Yobo Checklist in Korean Elderly
Hwang, H. S., PhD., P., Yoon, J. L., PhD., P., Park, B., PhD., P., Choi, H. R., PhD., P., Kwon, I. S., PhD., P., et al. (2012) · Journal of the Korean Geriatrics Society · doi:10.4235/jkgs.2012.16.3.121 · Cited by 9
Mohamad, M. I., Ebeid, S. M., Khater, M. S., & Alsadany, M. A. (2018) · Europe PMC (PubMed Central) · Cited by 9
Seo, A.-R., Kim, M.-J., Kim, B., Seo, Y.-M., Lee, G.-Y., Park, K., & Yoo, J. (2021) · Yonsei Medical Journal · doi:10.3349/ymj.2021.62.3.249 · Cited by 8
Association of CHA2DS2-VASc and HAS-BLED to frailty and frail outcomes: From the TREAT-AF study
Pundi, K. N., Perino, A. C., Fan, J., Din, N., Szummer, K. E., Heidenreich, P. A., & Turakhia, M. P. (2023) · American Heart Journal · doi:10.1016/j.ahj.2023.03.015 · Cited by 9
Lin, C., Kuo, L., Lin, Y.-S., Chang, C., Hu, F., Chen, Y., Lin, C.-T., & Su, F. (2022) · Journal of Medical and Biological Engineering · doi:10.1007/s40846-022-00759-8 · Cited by 9
“As shown in Table 2, the average SOF scores in the control and AIFASE groups were 1.0 ± 1.5 and 1.4 ± 1.2, respectively, suggesting that most of the participants were in the pre-frail stage.”
MethodInfluentialChang, W.-N., Tzeng, P.-L., Huang, W.-J., Lin, Y., Lin, K., Wen, C., Chou, Y., Liao, Y., Hsueh, M., & Chan, D. (2023) · European Review of Aging and Physical Activity · doi:10.1186/s11556-023-00324-5 · Cited by 8
“Among the several operational criteria for assessing frailty risk, two theories are most widely accepted: one theory involves the definition of frailty based on a phenotypic model, such as the Fried Frailty Phenotype (FFP) and the Study of Osteoporotic Fractures (SOF) index, that mainly focuses on the physical conditi…”
Background
Metadata
- Authors
- Ensrud, K. E., Ewing, S. K., Cawthon, P. M., Fink, H. A., Taylor, B. C., Cauley, J. A., Dam, T., Marshall, L. M., Orwoll, E. S., Cummings, S. R., & for the Osteoporotic Fractures in Men Research Group
- Affiliations
- University of Minnesota (US)
- ORCID
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2009-03
- Volume
- 57
- Issue
- 3
- Pages
- 492-498
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC2861353
- OpenAlex
- W1525398982
- Cited by
- 636
- References
- 38
- Citations by year
- 2026: 19 · 2025: 26 · 2024: 33 · 2023: 31 · 2022: 53 · 2021: 42 · 2020: 58 · 2019: 36 · 2018: 37 · 2017: 48 · 2016: 41 · 2015: 40 · 2014: 33 · 2013: 34 · 2012: 42
- FWCI
- 24.65
- 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 Institutes of Health
- National Institute on Aging (U01-AG-18197, U01AG018197, U01AG027810, U01AG042140)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (U01AR45614, U01-AR45632, U01 AR45647, U01AR045583, U01 AR-45583, U01-AR-45654, U01AR045580, U01AR045632, U01AR045654, U01AR045614, U01AR045647, U01AR066160, U01AR45580)
- National Center for Research Resources (UL1RR024140)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- frailty index, older men, falls, disability, fracture, mortality, frailty assessment, instrumental activities of daily living, weight loss, grip strength, energy status, physical activity
- MeSH terms
- Accidental Falls, Activities of Daily Living, Aged, 80 and over, Disability Evaluation, Follow-Up Studies, Fractures, Spontaneous, Humans, Male, Prospective Studies, Risk, Weight Loss, Geriatric Assessment, Proportional Hazards Models, Survival Analysis, Frail Elderly, Hand Strength, Mobility Limitation
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