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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

Doi : 10.1016/j.rehab.2022.101675 
Natália B. Moreira a, Paulo C.B. Bento b, Edgar Vieira c, José L.P. da Silva d, André L.F. Rodacki b,
a Universidade Federal do Paraná, Departamento de Prevenção e Reabilitação em Fisioterapia, Rua Coronel H dos Santos, Jardim das Américas, 100 Centro Politécnico, Curitiba, Paraná, Brazil, 81530-000 
b Universidade Federal do Paraná, Departamento de Educação Física, Rua Coronel H dos Santos, Jardim das Américas, 100. - Centro Politécnico, Curitiba, Paraná, Brazil, 81530-000 
c Florida International University, Department of Physical Therapy, Nicole Wertheim College of Nursing and Health Sciences, and Department of Neuroscience, Herbert Wertheim College of Medicine, Miami, FL, USA. 
d Universidade Federal do Paraná, Departamento de Estatística, Rua Coronel H dos Santos, Jardim das Américas, 100. - Centro Politécnico, Curitiba, Paraná, Brazil, 81530-000 

Corresponding Author: Dr. André Luiz Felix Rodacki, Universidade Federal do Paraná, Departamento de Educação Física, Rua Coronel H dos Santos, Jardim das Américas, 100. - Centro Politécnico, Curitiba, Paraná, Brazil, 81530-000. TellL +55 41 9912-98595Universidade Federal do ParanáDepartamento de Educação Física, Rua Coronel H dos SantosJardim das Américas, 100. - Centro PolitécnicoCuritibaParaná81530-000Brazil
Sous presse. Manuscrit accepté. Disponible en ligne depuis le Friday 13 May 2022

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.

Le texte complet de cet article est disponible en PDF.

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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