Skip to main content

Advertisement

SpringerLink
Log in

The Italian version of the “frailty index” based on deficits in health: a validation study

  • Original Article
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Background and Aim

Several measurements were taken for frailty classification in geriatric population. “Frailty index” is based on “deficits in health,” but it is still not available in Italian version. Thus, the aim of the present work was to validate a version of “frailty index” for the Italian geriatric community.

Methods

The validation of Italian frailty index (IFi) is based on a cohort study that enrolled 1077 non-disabled outpatients aged 65 years or older (81.3 ± 6.5 years) in Naples (Italy). IFi has been expressed as a ratio of deficits present/deficits considered after a comprehensive geriatric assessment. IFi was stratified in light, moderate and severe frailty. Mortality, disability (considering an increase in ADL lost ≥1 from the baseline) and hospitalization were considered at 3, 6, 12, 18 and 24 months of follow-up. Area under curve (AUC) was evaluated for both Fried’s and IFi frailty index.

Result

At the end of follow-up, mortality increased from 1.0 to 30.3%, disability from 40.9 to 92.3% and hospitalization from 0.0 to 59.0% (p < 0.001 for trend). Multivariate analysis shows that the relative risk for unit increase in IFi is 1.09 (95% CI = 1.01–1.17, p = 0.013) for mortality, 1.04 (95% CI = 1.01–1.06, p = 0.024) for disability and 1.03 (95% CI = 1.01–1.07, p = 0.041) for hospitalization. AUC is higher in IFi with respect to Fried’s frailty index when considering mortality (0.809 vs. 0.658, respectively), disability (0.800 vs. 0.729, respectively) and hospitalization (0.707 vs. 0.646, respectively).

Conclusions

IFi is a valid measure of frailty after the comprehensive geriatric assessment in an Italian cohort of non-institutionalized patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Vaupel JW (2010) Biodemography of human ageing. Nature 464:536–542

    Article  CAS  Google Scholar 

  2. Morley JE, Vellas B, van Kan GA (2013) Frailty consensus: a call to action. J Am Med Dir Assoc 14:392–397

    Article  Google Scholar 

  3. Strandberg TE, Pitkälä KH (2007) Frailty in elderly people. Lancet 369:1328–1329

    Article  Google Scholar 

  4. Weiss CO (2011) Frailty and chronic diseases in older adults. Clin Geriatr Med 27:39–52

    Article  Google Scholar 

  5. Fried LP, Tangen CM, Walston J et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:M146–M156

    Article  CAS  Google Scholar 

  6. Rockwood K, Mitnitski A (2007) Frailty in relation to the accumulation of deficits. J Gerontol A Biol Sci Med Sci 62:722–727

    Article  Google Scholar 

  7. Kulminski AM, Ukraintseva SV, Kulminskaya IV et al (2008) Cumulative deficits better characterize susceptibility to death in elderly people than phenotypic frailty: lessons from the Cardiovascular Health Study. J Am Geriatr Soc 56:898–903

    Article  Google Scholar 

  8. Cawthon PM, Marshall LM, Michael Y (2007) For Osteoporotic Fractures in Men Research Group. Frailty in older men: prevalence, progression, and relationship with mortality. J Am Geriatr Soc 55:1216–1223

    Article  Google Scholar 

  9. Cacciatore F, Abete P, Mazzella F et al (2005) Frailty predicts long-term mortality in elderly subjects with chronic heart failure. Eur J Clin Invest 35:723–730

    Article  CAS  Google Scholar 

  10. Bergman H, Ferrucci L, Guralnik J et al (2007) Frailty: an emerging research and clinical paradigm–issues and controversies. J Gerontol A Biol Sci Med Sci 62:731–737

    Article  Google Scholar 

  11. Theou O, Brothers TD, Mitnitski A et al (2013) Operationalization of frailty using eight commonly used scales and comparison of their ability to predict all-cause mortality. J Am Geriatr Soc 61:1537–1551

    Article  Google Scholar 

  12. Dent E, Kowal P, Hoogendijk EO (2016) Frailty measurement in research and clinical practice: a review. Eur J Intern Med 31:3–10

    Article  Google Scholar 

  13. Kulminski A, Yashin A, Arbeev K et al (2007) Cumulative index of health disorders as an indicator of aging-associated processes in the elderly: results from analyses of the national long term care survey. Mech Ageing Dev 128:250–258

    Article  CAS  Google Scholar 

  14. Kulminski A, Ukraintseva SV, Akushevich IV et al (2007) Cumulative index of health deficiencies as a characteristic of long life. J Am Geriatr Soc 55:935–940

    Article  Google Scholar 

  15. Goggins WB, Woo J, Sham A et al (2005) Frailty index as a measure of personal biological age in a Chinese population. J Gerontol A Biol Sci Med Sci 60A:1046–1051

    Article  Google Scholar 

  16. Woo J, Goggins W, Sham A et al (2005) Social determinants of frailty. Gerontology 51:402–408

    Article  CAS  Google Scholar 

  17. Cacciatore F, Abete P, Ferrara N et al (1997) The role of blood pressure in cognitive impairment in an elderly population. Osservatorio geriatrico campano group. J Hypertens 15:135–142

    Article  CAS  Google Scholar 

  18. Testa G, Cacciatore F, Galizia G et al (2011) Depressive symptoms predict mortality in elderly subjects with chronic heart failure. Eur J Clin Invest 41:1310–1317

    Article  Google Scholar 

  19. Testa G, Cacciatore F, Galizia G et al (2009) Charlson Comorbidity Index does not predict long-term mortality in elderly subjects with chronic heart failure. Age Ageing 38:734–740

    Article  Google Scholar 

  20. Katz S, Ford AB, Moskowitz RW et al (1963) Studies of illness in the aged. The index of BADL; a standardized measure of biological and psychological functions. JAMA 185:94–99

    Article  Google Scholar 

  21. Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186

    Article  CAS  Google Scholar 

  22. Kaiser MJ, Bauer JM, Rämsch C et al (2010) Mini Nutritional Assessment International Group: frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc 58:1734–1738

    Article  Google Scholar 

  23. Tinetti ME, Richman D, Powell L (1990) Falls efficacy as a measure of fear of falling. J Gerontol 45:239–243

    Article  Google Scholar 

  24. Goldberg A, Schepens S (2011) Measurement error and minimum detectable change in 4-meter gait speed in older adults. Aging Clin Exp Res 23:406–412

    Article  Google Scholar 

  25. Cacciatore F, Mazzella F, Viati L (2013) Physical activity is inversely related to drug consumption in elderly patients with cardiovascular events. Eur Rev Aging Phys Act 10:151–156

    Article  Google Scholar 

  26. Mazzella F, Cacciatore F, Galizia G et al (2010) Social support and long-term mortality in the elderly: role of Comorbidity. Arch Gerontol Geriatr 51:323–328

    Article  Google Scholar 

  27. Searle SD, Mitnitski A, Gahbauer EA et al (2008) A standard procedure for creating a frailty index. BMC Geriatr 30(8):24

    Article  Google Scholar 

  28. Zhu W, Zeng N, Wang N (2010) Sensitivity, specificity, accuracy, associated confidence interval and ROC analysis with practical SAS implementations. In: Proceedings on Nesug 2010. pp 1–9

  29. Bandeen-Roche K, Xue QL, Ferrucci L et al (2006) Phenotype of frailty: characterization in the women’s health and aging studies. J Gerontol A Biol Sci Med Sci 6:262–266

    Article  Google Scholar 

  30. Gill TM, Gahbauer EA, Han L et al (2010) Trajectories of disability in the last year of life. N Engl J Med 362:1173–1180

    Article  CAS  Google Scholar 

  31. Lee L, Heckman G, Molnar FJ (2015) Frailty: identifying elderly patients at high risk of poor outcomes. Can Fam Physician 61:227–231

    PubMed  PubMed Central  Google Scholar 

  32. Theou O, Cann L, Blodgett J et al (2015) Modifications to the frailty phenotype criteria: systematic review of the current literature and investigation of 262 frailty phenotypes in the survey of health, ageing, and retirement in Europe. Ageing Res Rev 21:78–94

    Article  Google Scholar 

  33. Mitnitski AB, Mogilner AJ, Rockwood K (2001) Accumulation of deficits as a proxy measure of aging. Sci World J 1:323–336

    Article  CAS  Google Scholar 

  34. Dent E, Perez-Zepeda M (2015) Comparison of five indices for prediction of adverse outcomes in hospitalized Mexican older adults: a cohort study. Arch Gerontol Geriatr 60:89–95

    Article  Google Scholar 

  35. Dent E, Chapman I, Howell S et al (2014) Frailty and functional decline indices predict poor outcomes in hospitalized older people. Age Ageing 43:477–484

    Article  Google Scholar 

  36. Hubbard RE, O’Mahony MS, Woodhouse KW (2009) Characterizing frailty in the clinical setting—a comparison of different approaches. Age Ageing 38:115–119

    Article  Google Scholar 

  37. Ensrud KE, Ewing SK, Taylor BC et al (2007) For study of osteoporotic fractures research group. Frailty and risk of falls, fracture, and mortality in older women: the study of osteoporotic fractures. J Gerontol A Biol Sci Med Sci 62:744–751

    Article  Google Scholar 

  38. Bilotta C, Nicolini P, Case A et al (2012) Frailty syndrome diagnosed according to the study of osteoporotic fractures (SOF) criteria and adverse health outcomes among community-dwelling older outpatients in Italy. A one-year prospective cohort study. Arch Gerontol Geriatr 54:e23–e28

    Article  Google Scholar 

  39. Rolfson DB, Majumdar SR, Tsuyuki RT et al (2006) Validity and reliability of the Edmonton frail scale. Age Ageing 35:526–529

    Article  Google Scholar 

  40. Partridge JS, Fuller M, Harari D et al (2015) Frailty and poor functional status are common in arterial vascular surgical patients and affect postoperative outcomes. Int J Surg 18:57–63

    Article  Google Scholar 

  41. Graham MM, Galbraith PD, O’Neill D et al (2013) Frailty and outcome in elderly patients with acute coronary syndrome. Can J Cardiol 29:1610–1615

    Article  Google Scholar 

  42. Hilmer SN, Perera V, Mitchell S et al (2009) The assessment of frailty in older people in acute care. Australas J Ageing 28:182–188

    Article  Google Scholar 

  43. Morley JE, Malmstrom TK, Miller DK (2012) A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging 16:601–608

    Article  CAS  Google Scholar 

  44. Woo J, Leung J, Morley JE (2012) Comparison of frailty indicators based on clinical phenotype and the multiple deficit approach in predicting mortality and physical limitation. J Am Geriatr Soc 60:1478–1486

    Article  Google Scholar 

  45. Malmstrom TK, Miller DK, Morley JE (2014) A comparison of four frailty models. J Am Geriatr Soc 62:721–726

    Article  Google Scholar 

  46. Pilotto A, Ferrucci L, Franceschi M et al (2008) Development and validation of a multidimensional prognostic index for one-year mortality from comprehensive geriatric assessment in hospitalized older patients. Rejuvenation Res 11:151–161

    Article  Google Scholar 

  47. Gobbens RJ, van Assen MA, Luijkx KG et al (2010) The Tilburg frailty indicator: psychometric properties. J Am Med Dir Assoc 11:344–355

    Article  Google Scholar 

  48. Raiche M, Hebert R, Dubois MF (2008) PRISMA-7: a case-finding tool to identify older adults with moderate to severe disabilities. Arch Gerontol Geriatr 47:9–18

    Article  Google Scholar 

  49. Peters LL, Boter H, Buskens E et al (2012) Measurement properties of the Groningen frailty indicator in home-dwelling and institutionalized elderly people. J Am Med Dir Assoc 13:546–551

    Article  Google Scholar 

  50. Hebert R, Bravo G, Korner-Bitensky N et al (1996) Predictive validity of a postal questionnaire for screening community-dwelling elderly individuals at risk of functional decline. Age Ageing 25:159–167

    Article  CAS  Google Scholar 

  51. Subra J, Gillette-Guyonnet S, Cesari M et al (2012) The integration of frailty into clinical practice: preliminary results from the Gerontopole. J Nutr Health Aging 16:714–720

    Article  CAS  Google Scholar 

  52. Fukutomi E, Okumiya K, Wada T et al (2015) Relationships between each category of 25-item frailty risk assessment (Kihon Checklist) and newly certified older adults under Long-Term Care Insurance: a 24-month follow-up study in a rural community in Japan. Geriatr Gerontol Int 15:864–871

    Article  Google Scholar 

  53. Rubenstein LZ, Josephson KR, Wieland GD et al (1984) Effectiveness of a geriatric evaluation unit. A randomized clinical trial. N Engl J Med 311:1664–1670

    Article  CAS  Google Scholar 

  54. Jones DM, Song X, Rockwood K (2004) Operationalizing a frailty index from a standardized comprehensive geriatric assessment. J Am Geriatr Soc 52:1929–1933

    Article  Google Scholar 

  55. Jones D, Song X, Mitnitski A et al (2005) Evaluation of a frailty index based on a comprehensive geriatric assessment in a population based study of elderly Canadians. Aging Clin Exp Res 17:465–471

    Article  Google Scholar 

  56. Rockwood K, Rockwood MR, Mitnitski A (2010) Physiological redundancy in older adults in relation to the change with age in the slope of a frailty index. J Am Geriatr Soc 58:318–323

    Article  Google Scholar 

  57. Hamaker ME, Jonker JM, de Rooij SE et al (2012) Frailty screening methods for predicting outcome of a comprehensive geriatric assessment in elderly patients with cancer: a systematic review. Lancet Oncol. 13:e437–e444

    Article  Google Scholar 

  58. Lee L, Heckman G, Molnar FJ (2015) Frailty: identifying elderly patients at high risk of poor outcomes. Can Fam Physician 61(3):227–231

    PubMed  PubMed Central  Google Scholar 

  59. Zaslavsky O, Thompson H, Demiris G (2012) The role of emerging information technologies in frailty assessment. Res Gerontol Nurs 5:216–228

    Article  Google Scholar 

  60. Cacciatore F, Testa G, Galizia G et al (2013) Clinical frailty and long-term mortality in elderly subjects with diabetes. Acta Diabetol 50:251-260

    Article  Google Scholar 

  61. Sergi G, Veronese N, Fontana L et al (2015) Pre-frailty and risk of cardiovascular disease in elderly men and women: the Pro.V.A. study. J Am Coll Cardiol 65(10):976–983

    Article  Google Scholar 

  62. Kojima G, Taniguchi Y, Iliffe S, et al (2016) Frailty as a predictor of alzheimer disease, vascular dementia, and all dementia among community-dwelling older people: a systematic review and meta-analysis. J Am Med Dir Assoc 17:881–888

    Article  Google Scholar 

  63. Galizia G, Cacciatore F, Testa G et al (2011) Role of clinical frailty on long-term mortality of elderly subjects with and without chronic obstructive pulmonary disease. Aging Clin Exp Res 23:118–125

    Article  Google Scholar 

  64. Cesari M, Gambassi G, van Kan GA et al (2014) The frailty phenotype and the frailty index: different instruments for different purposes. Age Ageing 43:10–12

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Translational Medical Sciences, University of Naples “Federico II”, 80131, Naples, Italy

    Pasquale Abete, Claudia Basile, Giulia Bulli, Francesco Curcio, Ilaria Liguori, Gaetano Gargiulo, Assunta Langellotto, Gianluca Testa, Gianluigi Galizia, Domenico Bonaduce & Francesco Cacciatore

  2. Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy

    David Della-Morte

  3. IRCCS San Raffaele Pisana, Rome, Italy

    David Della-Morte

  4. Division of Internal Medicine, AOU Ruggi d’Aragona, Salerno, Italy

    Gaetano Gargiulo

  5. Division of Geriatrics, Ospedale “S. Maria di Ca’ Foncello”, Treviso, Italy

    Assunta Langellotto

  6. Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy

    Gianluca Testa

  7. IRCCS Salvatore Maugeri Foundation, Scientific Institute of Veruno, Novara, Italy

    Gianluigi Galizia

Authors
  1. Pasquale Abete
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Claudia Basile
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Giulia Bulli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Francesco Curcio
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ilaria Liguori
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. David Della-Morte
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gaetano Gargiulo
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Assunta Langellotto
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Gianluca Testa
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Gianluigi Galizia
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Domenico Bonaduce
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Francesco Cacciatore
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pasquale Abete.

Ethics declarations

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

The study protocol was approved by the University of Naples Federico II (Comitato Etico per le attività Biomediche “Carlo Romano” prot. n.211/2013).

Informed consent

All participants provided informed consent at baseline and at follow-up.

Appendix 1

Appendix 1

figure a

Paziente

Cart. cl.

Nato il__/__/__

Altezza = m

Peso = Kg

Tel.

P

1. Aiuto nel lavarsi

SI = 1

No = 0

    

2. Aiuto nel vestirsi

SI = 1

No = 0

    

3. Aiuto nel sedersi o alzarsi dalla sedia

SI = 1

No = 0

    

4. Aiuto nel camminare in casa

SI = 1

No = 0

    

5. Aiuto nel mangiare

SI = 1

No = 0

    

6. Aiuto nella cura della casa

SI = 1

No = 0

    

7. Aiuto nell’utilizzare il bagno

SI = 1

No = 0

    

8. Aiuto nel salire o scendere le scale

SI = 1

No = 0

    

9. Aiuto nell’alzare 4.5 kg

SI = 1

No = 0

    

10. Aiuto nel fare la spesa

SI = 1

No = 0

    

11. Aiuto nei lavori di casa

SI = 1

No = 0

    

12. Aiuto nel preparare i pasti

SI = 1

No = 0

    

13. Aiuto nell’assumere i farmaci

SI = 1

No = 0

    

14. Aiuto nella gestione del denaro

SI = 1

No = 0

    

15. Perdita di più di 4.5 kg di peso nell’ultimo anno

SI = 1

No = 0

    

16. Giudizio sulla propria salute

Scarsa = 1

Discreta = 0.75

Buona = 0.5

Molto buona = 0.25

Eccellente = 0

 

17. Come è cambiata la sua salute nell’ultimo anno?

Peggiorata = 1

Migliorata/stessa = 0

    

18. Persistenza a letto almeno 1/2 giornata per motivi di salute, nell’ultimo mese?

SI = 1

No = 0

    

19. Riduzione della solita attività nell’ultimo mese?

SI = 1

No = 0

    

20. Uscire

<3 Giorni = 1

≥3 Giorni = 0

    

21. Affaticarsi per qualsiasi cosa

Spesso = 1

Qualche volta = 0.5

Raramente = 0

   

22. Sentirsi depresso

Spesso = 1

Qualche volta = 0.5

Raramente = 0

   

23. Sentirsi infelice

Spesso = 1

Qualche volta = 0.5

Raramente = 0

   

24. Social support score (vedi allegato 1)

>13 = 1

6–13 = 0.5

1–5 = 0

   

25. Avere difficoltà a mettersi in moto

Spesso = 1

Qualche volta = 0.5

Raramente = 0

   

26. Ipertensione

SI = 1

Sospetta = 0.5

No = 0

   

27.Angina pectoris

SI = 1

Sospetta = 0.5

No = 0

   

28. Insufficienza cardiaca cronica

SI = 1

Sospetta = 0.5

No = 0

   

29. Ictus

SI = 1

Sospetta = 0.5

No = 0

   

30. Cancro

SI = 1

Sospetta = 0.5,

No = 0

   

31. Diabete

SI = 1

Sospetta = 0.5

No = 0

   

32. Artrosi

SI = 1

Sospetta = 0.5

No = 0

   

33. Broncopneumopatia cronica

SI = 1

Sospetta = 0.5

No = 0

   

34. MMSE

<10 = 1

11–17 = 0.75

18–20 = 0.5

20–24 = 0.25

>24 = 0

 

35. BMI

<18.5, ≥30 = 1

25–<30 = 0.5

18.5–24.9 = 0

   

36. Picco flusso espiratorio = _______L/min 1 = ______ 2 = _______ 3 = ______

≤340 (uomo), ≤310 (donna) = 1

>340 (uomo), >310 (donna) = 0

    

37. Forza muscolare sollevamento = Kg 1 = ______ 2 = _______ 3 = ______

≤12 (uomo), ≤9 (donna) = 1

>12 (uomo), >9 (donna) = 0

    

38. Forza muscolare presa = Kg 1 = ______ 2 = _______ 3 = ______

Uomo = 1

Uomo = 0

    

BMI ≤24,

Kg ≤29

BMI ≤24

Kg >29

    

BMI 24.1–28

Kg ≤30

BMI 24.1–28

Kg >30

BMI >28

Kg ≤32

BMI >28

Kg >32

Donna = 1

Donna = 0

    

BMI ≤23

Kg ≤17

BMI ≤23

Kg >17

    

BMI 23.1–26

Kg ≤ 17.3

BMI 23.1–26

Kg >17

BMI 26.1–29

Kg ≤18

BMI 26.1–29

Kg >18

BMI >29

Kg ≤21

BMI >29

Kg >21

39. Mini nutritional Assessment (vedi allegato 2)

<17 = 1

17–23.5 = 0.5

24 = 0

   

40. Tempo impiegato per percorrere 4 metri con passo rapido (sec)

>10 = 1

≤10 = 0

    

Totale

Scala supporto sociale

1. Stato civile

Vedovo o celibe = 1

Coniugato = 0

2. Figli viventi

No = 1

Sì = 0

3. Fratelli e sorelle viventi

No = 1

Sì = 0

4. Frequenza di rapporti familiari

Mai, raramente = 1

Spesso, di frequente = 0

5. Con chi abita

Solo = 1

In compagnia = 0

6. Aiuto finanziario da parte dei familiari

No = 1

Sì = 0

7. Rapporti stretti con parenti non familiari

No = 1

Sì = 0

8. Aiuto concreto da parte dei familiari

No = 1

Sì = 0

9. Con quante persone del vicinato si vede almeno una volta a settimana?

Nessuno = 1

Almeno una = 0

10. Ha amici intimi?

No = 1

Sì = 0

11. Frequenza rapporti?

Mai, raramente = 1

Spesso, di frequente = 0

12. Frequenta posti pubblici?

Mai, raramente = 1

Spesso, di frequente = 0

13. Frequenta cinema-teatri?

Mai, raramente = 1

Spesso, di frequente = 0

14. Frequenta associazioni di volontariato-ricreative?

Mai, raramente = 1

Spesso, di frequente = 0

15. Legge i giornali?

Mai, raramente = 1

Spesso, di frequente = 0

16. Ascolta radio e/o vede TV?

Mai, raramente = 1

Spesso, di frequente = 0

17. Si prende cura dei bambini?

Mai, raramente = 1

Spesso, di frequente = 0

Totale

  1. Dalla analisi della tabella si ottiene uno score in cui i punteggi più alti individuano i soggetti con un basso livello di supporto sociale: il più basso livello si individua con un punteggio di 17
  2. Supporto sociale buono: 1–5
  3. Supporto sociale discreto: 6–13
  4. Supporto sociale scarso: 14–17

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Abete, P., Basile, C., Bulli, G. et al. The Italian version of the “frailty index” based on deficits in health: a validation study. Aging Clin Exp Res 29, 913–926 (2017). https://doi.org/10.1007/s40520-017-0793-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40520-017-0793-9

Keywords

Search

Navigation