Abstract
ObjectiveThe objective of this study was to examine whether the capacity of an age-related deficit accumulation index (the so-called Frailty Index [FI] proposed by Rockwood) to predict mortality in a nursing home population. Design, Setting, and ParticipantsData are from a longitudinal cohort study (ie, the Incidence of pNeumonia and related ConseqUences in nursing home Residents [INCUR]) of 773 older persons (74.4% women) living in 13 French nursing homes. MeasurementsThe FI was computed as the ratio between actual and 30 potential deficits the participant might have presented at the baseline visit (range between 0 [no deficit] and 1 [30 deficits]). Death events were monitored and detected over a 12-month follow-up. The risk of death was estimated using Cox proportional hazards models. ResultsMean age of participants was 86.2 (SD 7.5) years, with a mean FI of 0.35 (SD 0.11). At the end of the follow-up, 135 (17.4%) death events were recorded. A positive association between the FI and mortality (per 0.01 FI increment: age- and gender-adjusted hazard ratio 1.018, 95% confidence interval 1.002–1.035, P = .03) was reported. The use of the traditional 0.25 cut-point for detecting the frailty status is inadequate in this population. ConclusionThe FI is able to predict mortality even in very old and complex elders, such as nursing home residents.
Published Version
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