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Beyond the Health Deficit Count: Examining Deficit Patterns in a Deficit‐Accumulation Frailty Index
Author(s) -
OlivieriMui Brianne L.,
Shi Sandra M.,
McCarthy Ellen P.,
Habtemariam Daniel,
Kim Dae H.
Publication year - 2021
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.16955
Subject(s) - medicine , dementia , latent class model , comorbidity , confidence interval , gerontology , frailty index , psychological intervention , demography , psychiatry , disease , statistics , mathematics , sociology
Background/Objectives Exploring deficit patterns among frail people may reveal subgroups of different prognostic importance. Design Analysis of National Health and Aging Trends Study. Setting Community. Participants Community dwelling older adults with mild to moderate frailty (deficit‐accumulation frailty index (FI) of 0.25–0.40) (n = 1821). Measurements Latent class analysis identified distinct clinical subgroups based on comorbidity (range: 0–10), National Health and Aging Trends Study dementia classification, and short physical performance battery (SPPB) (range: 0–12). Survival analyses compared 5‐year mortality by subgroups. Results Three latent classes existed: Class 1 (n = 831, mean FI = 0.30) had 2.7% probable dementia, high comorbidities (mean = 3.6), and low physical impairment (SPPB mean = 9.9); Class 2 (n = 734, mean FI = 0.32) had 6.9% probable dementia, low comorbidities (mean = 2.8), and moderate physical impairment (SPPB mean = 6.2); Class 3 (n = 256, mean FI = 0.34) had 20.7% probable dementia, low comorbidities (mean = 2.4), and high physical impairment (SPPB mean = 2.0). Compared to Class 1, Classes 2 and 3 experienced higher 5‐year mortality (C2: 1.28 (95% confidence intervals (CI) = 1.00–1.62); C3: 1.87 (95% CI = 1.29–2.73)). Conclusion Deficit patterns among the mild‐to‐moderately frail provide additional prognostic information and highlight opportunities for preventive interventions.