School of Physiotherapy, Dalhousie University, Halifax, NS, B3H 4R2, Canada.
Geriatric Medicine, Dalhousie University, Halifax, NS, B3H 2E1, Canada.
Age Ageing. 2023 Dec 1;52(12). doi: 10.1093/ageing/afad221.
The frailty index is commonly used in research and clinical practice to quantify health. Using a health deficit accumulation model, a frailty index can be calculated retrospectively from data collected via survey, interview, performance test, laboratory report, clinical or administrative medical record, or any combination of these. Here, we offer a detailed 10-step approach to frailty index creation, with a worked example.
We identified 10 steps to guide the creation of a valid and reliable frailty index. We then used data from waves 5 to 12 of the Health and Retirement Study (HRS) to illustrate the steps.
The 10 steps are as follows: (1) select every variable that measures a health problem; (2) exclude variables with more than 5% missing values; (3) recode the responses to 0 (no deficit) through 1 (deficit); (4) exclude variables when coded deficits are too rare (< 1%) or too common (> 80%); (5) screen the variables for association with age; (6) screen the variables for correlation with each other; (7) count the variables retained; (8) calculate the frailty index scores; (9) test the characteristics of the frailty index; (10) use the frailty index in analyses. In our worked example, we created a 61-item frailty index following these 10 steps.
This 10-step procedure can be used as a template to create one continuous health variable. The resulting high-information variable is suitable for use as an exposure, predictor or control variable, or an outcome measure of overall health and ageing.
衰弱指数常用于研究和临床实践中，以量化健康状况。使用健康缺陷累积模型，可以根据通过调查、访谈、表现测试、实验室报告、临床或行政医疗记录收集的数据，或这些数据的任意组合，回顾性地计算衰弱指数。在这里，我们提供了一个详细的 10 步流程来创建衰弱指数，并提供了一个示例。
我们确定了 10 个步骤来指导有效和可靠的衰弱指数的创建。然后，我们使用健康与退休研究（HRS）第 5 至 12 波的数据来说明这些步骤。
这 10 个步骤如下：（1）选择每个测量健康问题的变量；（2）排除缺失值超过 5%的变量；（3）将反应重新编码为 0（无缺陷）至 1（缺陷）；（4）当编码缺陷太少（<1%）或太多（>80%）时排除变量；（5）筛选与年龄相关的变量；（6）筛选与其他变量相关的变量；（7）统计保留的变量数；（8）计算衰弱指数得分；（9）测试衰弱指数的特征；（10）在分析中使用衰弱指数。在我们的示例中，我们按照这 10 个步骤创建了一个 61 项的衰弱指数。
此 10 步程序可用作创建单一连续健康变量的模板。由此产生的高信息量变量适用于作为暴露、预测或控制变量，或作为整体健康和衰老的结果衡量指标。
