37 ‘FRAIL’ BY DIFFERENT MEASURES: A COMPARISON OF 8-YEAR MORTALITY IN THE IRISH LONGITUDINAL STUDY ON AGEING (TILDA)

Abstract

Abstract Background Frailty is a state of dysregulation in multiple physiological systems and vulnerability to stressors. Many frailty identification tools exist that differ in their conceptualisation vis-à-vis morbidity, disability, cognition, and other geriatric assessment dimensions. We compared the ability of four different frailty identification tools to predict 8-year mortality in TILDA. Methods We included TILDA Wave 1 (2010) participants who had data for frail state classification according to four tools: the Fried’s physical Frailty Phenotype (FP: frail if ≥3 features present), Morley’s FRAIL scale (frail if ≥3), a 32-item Frailty Index (FI ≥ 0.25), and the Clinical Frailty Scale classification tree (CFS ≥ 5). Mortality was ascertained at Wave 5 (2018). Binary logistic regression models controlling for age and sex were computed for the extraction of Odds Ratios (OR) and 95% Confidence Intervals (CI). Results At Wave 1, there were 5,700 participants (mean age 63, range 50–98 years, 54% women) with data for frailty classification according to all four tools. The prevalences of frailty were 2.3% by FRAIL, 3.8% by FP, 10.9% by CFS, and 12.8% by FI. 8-year mortality proportions were 41.2%, 44.9%, 25.3% and 27.0%, respectively. The highest age and sex-adjusted OR for 8-year mortality was for FRAIL (OR 4.86, 95% CI 3.18–7.41, P < 0.001), followed by FP (OR 3.72, 95% CI 2.64–5.23, P < 0.001), FI (OR 2.20, 95% CI 1.76–2.74, P < 0.001), and CFS (OR 1.95, 95% CI 1.53–2.47, P < 0.001). Conclusion All four frailty tools significantly predicted 8-year mortality in TILDA, but FRAIL and FP seemed more specific. Different frailty identification tools may suit different population screening purposes.