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Which comorbidity index is more appropriate for geriatric patients from the frailty perspective?

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Key summary points

AbstractSection Aim

To evaluate the relationship between comorbidity indices and frailty scales in community-dwelling older adults.

AbstractSection Findings

The CIRS-G index was found to be superior to other indices in predicting the presence of frailty among comorbidity indices, and only GIC scores showed significant results in predicting mortality.

AbstractSection Message

Although CIRS-G seems to be the index most associated with physical, psychological and social frailty, no single comorbidity index should be recommended for predicting clinical outcomes in older adults.

Abstract

Objectives

This study examined the relationship between comorbidity indices and physical, psychologic and social frailty and 1-year mortality.

Methods

A cross-sectional analysis was conducted with 136 community-dwelling older adults. The relationship of 4 comorbidity indices (CIRS-G, ACCI, GIC, ICED) with 3 different frailty scales (FRAIL, CFS, TFI) was examined.

Results

The participants’ median age was 72 years (65–90); 62% of the participants were female. Overall, 15.4% of the participants were living with frailty according to the FRAIL scale, 27.9% of them according to the CFS, 58.8% of them according to the TFI, 47.7% of them living with psychological frailty, and 28.6% of them living with social frailty. There were significant and moderate correlations between CIRS-G and FRAIL, CFS and TFI total scores, TFI-Psychological scores and TFI-Social scores (respectively; p < 0.001, r = 0.530; p < 0.001, r = 0.471; p < 0.001, r = 0.535; p < 0.001, r = 0.402; p = 0.016 r = 0.206). AUC for CIRS-G was calculated as 0.716 among comorbidity indices in predicting the presence of frailty according to the FRAIL scale (p = 0.002, 95%CI [0.60–0.82]), 0.765 according to the CFS (p < 0.001, 95%CI [0.66–0.86]), 0.746 according to the TFI (p < 0.001, 95%CI [0.66–0.82]).

Conclusion

The CIRS-G index was found to be superior to other indices in predicting the presence of frailty of comorbidity indices, and only GIC scores showed significant results in predicting mortality. However, it would not be the right approach to recommend a single comorbidity index when evaluating older adults.

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Funding

This research did not receive any funding from agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Geriatrics Medicine, Faculty of Medicine, Hacettepe University Medical School, Altındag, Ankara, Turkey

    Merve Hafızoğlu, Zeynep Kahyaoğlu, Cafer Balcı, Meltem Gülhan Halil, Mustafa Cankurtaran & Burcu Balam Doğu

  2. Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    Ezgi Odacı Cömertoğlu

  3. Department of Geriatrics, Eskisehir City Hospital, Health Sciences University, Eskisehir, Turkey

    Yelda Öztürk

  4. Department of Geriatrics Mehmet, Akif Inan Training and Research Hospital, Health Sciences University, Sanliurfa, Turkey

    Çağatay Çavuşoglu

  5. Departments of Psychiatry, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    Özlem Erden Aki

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  1. Merve Hafızoğlu
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  2. Ezgi Odacı Cömertoğlu
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Correspondence to Merve Hafızoğlu.

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The study's ethics approval has taken from the Ankara Hacettepe University Department of Medicine clinical research ethics committee, and the decision number is GO23/62. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Hafızoğlu, M., Odacı Cömertoğlu, E., Öztürk, Y. et al. Which comorbidity index is more appropriate for geriatric patients from the frailty perspective?. Eur Geriatr Med 15, 115–125 (2024). https://doi.org/10.1007/s41999-023-00851-5

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