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5. Construction and Validation of a Frailty Index in Primary Care in Italy: The Health-Search Frailty Index

Author

Vetrano, Davide, Zucchelli, Alberto, Onder, Graziano, Bernabei, Roberto, Fratiglioni, Laura, Marengoni, Alessandra, and Lapi, Francesco

Subjects
Abstracts, Session 4395 (Paper), Health (social science), AcademicSubjects/SOC02600, Life-span and Life-course Studies, Frailty Measurement, Health Professions (miscellaneous)
Abstract

Recognizing frailty in primary care is important to implement personalized care pathways and for prognostication. The aim of this study was to build and validate a frailty index based on routinely collected primary care data in Italy. We used clinical data from 308,280 Italian primary care patients 60+ with at least 5 years of follow-up, part of the Health Search Database. A heuristic algorithm was used to select the deficits to be included in a highly performant frailty index. The fitness of the index was assessed through the c-statistics derived by survival models. Results were externally validated using the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). After testing 3.4 million of deficits combinations, 25 deficits were selected to be included in the Health Search Frailty Index (HS-FI). After adjusting by sex, age and geographical area, the HS-FI was associated with 5-year mortality (HR per 0.1 increase 1.99; 95%CI 1.95-2.02) and hospitalization rate (HR per 0.1 increase 1.25; 95%CI 1.23-1.27). In the external validation cohort, HS-FI independently predicted mortality, hospitalization, incident disability, incident dementia, and incident falls. This is the first frailty index built following a data-driven approach, using national representative primary care data. The implementation of such tool – derived by routinely collected data – in primary care software will ease the prompt, comparable and reliable recognition of frailty at the population level.

Published
2021

6. Beyond Chronological Age: Frailty and Multimorbidity Predict In-Hospital Mortality in Patients With Coronavirus Disease 2019

Author

Marengoni, Alessandra, primary, Zucchelli, Alberto, additional, Vetrano, Davide Liborio, additional, Armellini, Andrea, additional, Botteri, Emanuele, additional, Nicosia, Franco, additional, Romanelli, Giuseppe, additional, Beindorf, Eva Andrea, additional, Giansiracusa, Paola, additional, Garrafa, Emirena, additional, Ferrucci, Luigi, additional, Fratiglioni, Laura, additional, Bernabei, Roberto, additional, and Onder, Graziano, additional

Published
2020
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