Comparison of the Clinical-Functional Vulnerability Index and the Frailty Phenotype for the identification of falls in older individuals: a cross-sectional study - 13/05/22
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Highlights |
• | The number of phenotypes identified fallers more accurately than the categorical approach. |
• | The odds ratio for falling was 29.4 greater when 4 frailty phenotypes were present. |
• | The CFVI-20 more accurately identified fallers than the frailty phenotype. |
• | The odds ratio for falling increased by 11% per CFVI-20-unit change. |
Abstract |
Background |
: Frailty increases the risk of falls, disability and death in older adults. The Cardiovascular Health Study identified a frailty phenotype (the Fried Phenotype) that was primarily based on physical domains. Instruments that incorporate additional domains (e.g., cognitive, disability or mood) may more accurately identify falls.
Objectives |
: The study aimed i) to evaluate the association between falls and the number of phenotypes identified by the Fried Phenotype and CFVI-20 scores and ii) to compare the strength of the association between falls and each frailty instrument.
Methods |
: This study used the CFVI-20 and the Fried Phenotype and reported falls during the last twelve months. Logistic regression models, odds ratios (ORs), and ROC curves were used to identify associations and perform comparisons (p<0.05). The reporting of the study followed the Strobe guidelines.
Results |
: This study included 1,826 individuals (mean 70.9 (SD 7.3) years old). Prevalence of pre-frailty and low vulnerability was high (72% and 69%) and comparable between frailty instruments. The number of Fried phenotypes increased the odds of having fallen in the past 12 months (OR: 1.5 to 29.5) and the CFVI-20 scores (11% increase/unit change). The CFVI-20 identified falls more accurately than the Fried Phenotype (AUC: 0.68 vs. 0.60, p < 0.001).
Conclusions |
: The number of phenotypes and the CFVI-20 scores were associated with falls; continuous scores identified falls more accurately than categorical classifications. The CFVI-20 was more strongly associated with falls in community-dwelling older adults than the Fried Phenotype.
Le texte complet de cet article est disponible en PDF.Keywords : accidental falls, risk factors, aged, frail elderly
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