Comparing the prognostic value of geriatric health indicators: a population-based study
Open accessAbstract
Background: The identification of individuals at increased risk of poor health-related outcomes is a priority. Geriatric research has proposed several indicators shown to be associated with these outcomes, but a head-to-head comparison of their predictive accuracy is still lacking. We therefore aimed to compare the accuracy of five geriatric health indicators in predicting different outcomes among older persons: frailty index (FI), frailty phenotype (FP), walking speed (WS), multimorbidity, and a summary score including clinical diagnoses, functioning, and disability (the Health Assessment Tool; HAT). Methods: Data were retrieved from the Swedish National Study on Aging and Care in Kungsholmen, an ongoing longitudinal study including 3363 people aged 60+. To inspect the accuracy of geriatric health indicators, we employed areas under the receiver operating characteristic curve (AUC) for the prediction of 3-year and 5-year mortality, 1-year and 3-year unplanned hospitalizations (1+), and contacts with healthcare providers in the 6 months before and after baseline evaluation (2+). Results: FI, WS, and HAT showed the best accuracy in the prediction of mortality [AUC(95%CI) for 3-year mortality 0.84 (0.82–0.86), 0.85 (0.83–0.87), 0.87 (0.85–0.88) and AUC(95%CI) for 5-year mortality 0.84 (0.82–0.86), 0.85 (0.83–0.86), 0.86 (0.85–0.88), respectively]. Unplanned hospitalizations were better predicted by the FI [AUC(95%CI) 1-year 0.73 (0.71–0.76); 3-year 0.72 (0.70–0.73)] and HAT [AUC(95%CI) 1-year 0.73 (0.71–0.75); 3-year 0.71 (0.69–0.73)]. The most accurate predictor of multiple contacts with healthcare providers was multimorbidity [AUC(95%CI) 0.67 (0.65–0.68)]. Predictions were generally less accurate among younger individuals (< 78 years old). Conclusion: Specific geriatric health indicators predict clinical outcomes with different accuracy. Comprehensive indicators (HAT, FI, WS) perform better in predicting mortality and hospitalization. Multimorbidity exhibits the best accuracy in the prediction of multiple contacts with providers.
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A Frailty Index constructed with a similar number of variables was superior to other frailty tools in predicting mortality.
“Importantly, one study has shown that a FI constructed with a similar number of variables was superior to other frailty tools in predicting mortality [4].”
From Frailty index predicts poor outcome in COVID-19 patients (2020) · cites this paper as [4]
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- Authors
- Zucchelli, A., Vetrano, D. L., Grande, G., Calderón-Larrañaga, A., Fratiglioni, L., Marengoni, A., & Rizzuto, D.
- Affiliations
- Stockholm University (SE)
- Corresponding author
- Zucchelli, Alberto
- ORCID
- Venue
- BMC Medicine
- Published
- 2019-10-02
- Volume
- 17
- Issue
- 1
- Pages
- 185-185
- ISSN
- 1741-7015 (ISSN-L)
- PMC
- PMC6774220
- OpenAlex
- W2978966359
- Cited by
- 55
- References
- 80
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 7 · 2023: 9 · 2022: 12 · 2021: 9 · 2020: 11 · 2012: 1
- FWCI
- 4.21
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
- Funders
- Vetenskapsrådet (521-2013-8676, 2017-06088, 2016-00981)
- Forskningsrådet för Arbetsliv och Socialvetenskap (2016-07175, 2017-01764)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- frailty index, Fried frailty phenotype, walking speed, multimorbidity, health assessment tools, mortality prediction, emergency admissions, health care utilization, older adults, prognostic accuracy, population-based cohort, clinical diagnoses
- MeSH terms
- Frailty, Aged, Aged, 80 and over, Female, Persons with Disabilities, Health Status Indicators, Hospitalization, Humans, Longitudinal Studies, Male, Middle Aged, Mortality, Predictive Value of Tests, Prognosis, Sweden, Geriatric Assessment, 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.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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