Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
McMaster Institute for Research on Aging, Hamilton, Canada.
J Epidemiol Community Health. 2017 Aug;71(8):794-799. doi: 10.1136/jech-2016-208853. Epub 2017 Jul 5.
Frailty is a way to appreciate the variable vulnerability to declining health status of people as they age. No consensus for measuring frailty has been established. This study aimed to adapt a Frailty Index (FI) to the Canadian Longitudinal Study on Aging (CLSA) and evaluate its applicability in both younger and older adults.
An FI was created based on 90 potential health deficits collected from adults aged 45-85 years at recruitment (N=21 241, 49.0% male). The construct validity of this instrument and the factor structure of the health deficits were evaluated.
The direction of associations between the FI and other variables were consistent with hypotheses for construct validity. FI values were significantly associated with age (r=0.17; p<0.001), falls (r=0.12; p<0.001), injuries (r=0.12; p<0.001), formal home care (r =0.30; p<0.001), informal home care (r=0.32; p<0.001) and use of assistive devices (r=0.40; p<0.001). Values were negatively associated with male sex (r=-0.12; p<0.001), income (r=-0.34; p<0.001) and education (r=-0.17; p<0.001). Key factors among the health indicators were physical functioning, satisfaction with life and depressive symptoms. Results did not change when the sample was stratified by age and sex.
The FI is a feasible method to evaluate frailty and capture frailty-related heterogeneity in populations aged 45-85 years. In this study, the FI had good construct validity in middle-aged and older adults, showing expected correlations with sociodemographic factors consistently across age groups. This method can be easily reproduced in similar datasets, making the FI a generalisable instrument.
衰弱是一种评估人们随着年龄增长健康状况下降的易变脆弱性的方法。目前尚未达成衡量衰弱的共识。本研究旨在将衰弱指数（FI）应用于加拿大老龄化纵向研究（CLSA）并评估其在年轻和老年人群中的适用性。
基于招募时年龄在 45-85 岁的成年人（21241 人，49.0%为男性）中收集的 90 种潜在健康缺陷，创建了一个 FI。评估了该工具的结构效度和健康缺陷的因子结构。
FI 与其他变量之间的关联方向与结构效度假设一致。FI 值与年龄（r=0.17；p<0.001）、跌倒（r=0.12；p<0.001）、受伤（r=0.12；p<0.001）、正规家庭护理（r=0.30；p<0.001）、非正规家庭护理（r=0.32；p<0.001）和辅助设备的使用（r=0.40；p<0.001）显著相关。FI 值与男性性别（r=-0.12；p<0.001）、收入（r=-0.34；p<0.001）和教育（r=-0.17；p<0.001）呈负相关。健康指标中的关键因素是身体机能、生活满意度和抑郁症状。当按年龄和性别对样本进行分层时，结果并未改变。
FI 是评估 45-85 岁人群衰弱状况和捕捉与衰弱相关异质性的可行方法。在这项研究中，FI 在中年和老年人中具有良好的结构效度，在不同年龄组中与社会人口因素的预期相关性一致。这种方法可以在类似的数据集上轻松重现，使 FI 成为一种具有普遍性的工具。
