Predictive Capacity of Frailty Phenotype Toward Patterns of Disability Identified Using Latent Class Analysis.
Luisa Costanzo, Matteo Cesari, Luigi Ferrucci and 3 others
PMID 30772170WHAT IT FOUND
Frailty screening missed many older adults who later developed disability patterns.
When it flagged someone, that person often did decline. It was not good at catching most people who declined.
Key findings
01Over three years, older adults fell into three disability patterns: stable function, difficulty with complex activities, and global functional disability.
02In women, the frailty phenotype identified only 0.13 of those who developed the complex activity class, though it identified 0.42 of those who developed global disability.
03In women, 0.75 of those flagged by the frailty phenotype developed global disability, and 0.44 of those flagged developed loss of at least one basic daily activity.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The analysis used 997 of 1155 eligible participants, and excluded participants were slightly older and had a higher prevalence of women. The latent class model used 857 people who were alive and completed the 3-year evaluation, so people who died or were lost before follow-up were not included in the class analysis. Frailty was uncommon at baseline, and analyses were split by sex, which reduced the number of people at risk of each outcome and may bias estimates. Disability was self-reported, not performance-based. Functional decline could reflect major events such as falls, not only progressive aging. The study used only the frailty phenotype, so results cannot be extended to other frailty instruments. Findings come from one Italian community and may not translate to other populations.
Declared interests
The authors declared no personal or financial conflicts of interest.
The easy way to misread this
Do not conclude the frailty phenotype is a good screening tool for disability. In women it identified only 0.13 of those who developed the complex activity class, so a negative screen does not rule out decline.