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Predictive validity of two frailty tools for mortality in Chinese nursing home residents: frailty index based on common laboratory tests (FI-Lab) versus FRAIL-NH

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Abstract

Background

Little is known about frailty in Chinese nursing home residents.

Aims

(1) To evaluate the prevalence of frailty in nursing home residents according to the FI-Lab or FRAIL-NH; and (2) to compare the predictive validity of these two tools for mortality.

Methods

We conducted a prospective study in four nursing homes in China. Frailty was assessed using the fatigue, resistance, ambulation, illness, loss of weight, nutrition, and help with dressing questionnaire (FRAIL-NH) and frailty index based on common laboratory tests (FI-Lab), respectively. The survival status was collected via medical records or telephone interviews. Receiver-operating characteristic (ROC) curves were calculated to estimate the area under the ROC curves (AUCs) for FI-Lab and FRAIL-NH in relation to mortality. Cox proportional hazard models were applied to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality by FRAIL-NH and FI-Lab, separately.

Results

We included 329 participants. The FI-Lab score was significantly and strongly associated with the FRAIL-NH score (r = 0.799, p < 0.001). Frailty was defined as the FI-Lab score ≥ 0.3 or the FRAIL-NH score ≥ 6, and the prevalence of frailty was 56.2% and 58.7%, respectively. Seventy-three participants (22.7%) died during the 1-year follow-up. The FI-Lab (AUC 0.700, 95% CI 0.647–0.750) was slightly better than the FRAIL-NH (AUC 0.676, 95% CI 0.622–0.727) for predicting mortality (p = 0.025). After adjusted for age and gender, the increment of the FI-Lab score was associated with mortality (adjusted HR per 0.01 increment in score 1.07, 95% CI 1.05–1.09), the increment of the FRAIL-NH score was also associated with mortality (adjusted HR per 1 increment in score 1.28, 95% CI 1.19–1.46).

Conclusion

The FI-Lab and FRAIL-NH are valuable for predicting mortality in Chinese nursing home residents.

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Funding

This work was supported by the Health and Family Planning Commission of Sichuan Province (Grant number ZH2018-102) and the Sichuan Medical Association (Grant number S17054). The sponsors had no role in the design, methods, data collection, analysis, and preparation of this work.

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Authors and Affiliations

  1. The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China

    Ming Yang, Xiaoyi Hu & Lingling Xie

  2. Department of Healthcare, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China

    Yan Zhuo

Authors
  1. Ming Yang
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  2. Yan Zhuo
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  3. Xiaoyi Hu
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  4. Lingling Xie
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Corresponding author

Correspondence to Ming Yang.

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Conflict of interest

None of the authors has any conflict of interest related to this work.

Human and animal rights

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any study with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all the participants in this study or their legal proxies.

Additional information

Ming Yang and Yan Zhuo are contributed equally to this work.

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Yang, M., Zhuo, Y., Hu, X. et al. Predictive validity of two frailty tools for mortality in Chinese nursing home residents: frailty index based on common laboratory tests (FI-Lab) versus FRAIL-NH. Aging Clin Exp Res 30, 1445–1452 (2018). https://doi.org/10.1007/s40520-018-1041-7

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  • DOI: https://doi.org/10.1007/s40520-018-1041-7

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