Cited by 636Frailty in Older AdultsNutrition and Health in AgingPharmaceutical Practices and Patient Outcomes

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A Comparison of Frailty Indexes for the Prediction of Falls, Disability, Fractures, and Mortality in Older Men

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Ensrud, Kristine E., Ewing, Susan K., Cawthon, Peggy M., Fink, Howard A., Taylor, Brent C., Cauley, Jane A., Dam, Thuy‐Tien, Marshall, Lynn M., Orwoll, Eric S., Cummings, Steven R., for the Osteoporotic Fractures in Men Research Group·2009·Journal of the American Geriatrics Society

DOI 10.1111/j.1532-5415.2009.02137.xPMC PMC2861353

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Abstract

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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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: Ensrud, Kristine E.
Ewing, Susan K.
Cawthon, Peggy M.
Fink, Howard A.
Taylor, Brent C.
Cauley, Jane A.
Marshall, Lynn M.
Orwoll, Eric S.
Cummings, Steven R.
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
DOI: 10.1111/j.1532-5415.2009.02137.x
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
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
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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A Comparison of Frailty Indexes for the Prediction of Falls, Disability, Fractures, and Mortality in Older Men

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