Facultad de Enfermería, Escuela de Enfermería, Universidad Andrés Bello, Santiago, Chile.
Millennium Institute for Care Research (MICARE), Santiago, Chile.
Geroscience. 2024 Jun;46(3):3471-3479. doi: 10.1007/s11357-024-01097-0. Epub 2024 Feb 22.
We aimed to develop and assess a modified healthy aging index (HAI) among Chileans aged 60 years and older and compare its predictive ability for all-cause mortality risk with the frailty index (FI).
This prospective study analyzed data from the Chilean National Health Survey (CNHS) conducted in 2009-2010. We included 847 adults with complete data to construct the HAI and FI. The HAI comprised five indicators (lung function, systolic blood pressure, fasting glucose, cognitive status, and glomerular filtration rate), while the FI assessed frailty using a 36-item scale. HAI scores were calculated by summing the indicator scores, ranging from 0 to 10, with higher scores indicating poorer health. Receiver operating curves (ROC) and area under the curve (AUC) were used to assess predictive validity. Associations with all-cause mortality were assessed using Cox proportional hazard models adjusted by confounders.
The mean HAI score was 4.06, while the FI score was 0.24. The AUC for mortality was higher for the HAI than the FI (0.640, 95% confidence interval (CI) 0.601 to 0.679 vs. 0.586, 95% CI 0.545 to 0.627). After adjusting for confounders, the FI showed a higher mortality risk compared to the HAI (2.63, 95% CI 1.76 to 3.51 vs. 1.16, 95% CI 1.08 to 1.26).
The FI and HAI were valid predictors for all-cause mortality in the Chilean population. Integrating these indices into research and clinical practice can significantly enhance our capacity to identify at-risk individuals.
我们旨在为智利 60 岁及以上老年人开发和评估一个改良的健康老龄化指数（HAI），并将其预测全因死亡率风险的能力与衰弱指数（FI）进行比较。
本前瞻性研究分析了 2009-2010 年智利国家健康调查（CNHS）的数据。我们纳入了 847 名数据完整的成年人来构建 HAI 和 FI。HAI 包括五个指标（肺功能、收缩压、空腹血糖、认知状态和肾小球滤过率），而 FI 使用 36 项量表评估衰弱。HAI 评分通过将指标评分相加得出，范围为 0 至 10，得分越高表示健康状况越差。使用接收器操作曲线（ROC）和曲线下面积（AUC）评估预测有效性。使用 Cox 比例风险模型评估与全因死亡率的关联，并调整混杂因素。
HAI 评分的平均值为 4.06，FI 评分为 0.24。HAI 预测死亡率的 AUC 高于 FI（0.640，95%置信区间[CI] 0.601 至 0.679 与 0.586，95%CI 0.545 至 0.627）。在调整混杂因素后，FI 显示与 HAI 相比，死亡率风险更高（2.63，95%CI 1.76 至 3.51 与 1.16，95%CI 1.08 至 1.26）。
FI 和 HAI 是智利人群全因死亡率的有效预测指标。将这些指标纳入研究和临床实践中，可以显著提高我们识别高危个体的能力。
