A comparison between uni- and multidimensional frailty measures: prevalence, functional status, and relationships with disability

Figures & data

Table 1 Main characteristics of participants

Variable	n=267
Age, years, mean (SD)	73.4 (6.0)
Sex, n (%)
Male	107 (40.1)
Female	160 (59.9)
Place of birth, n (%)
North Italy	160 (59.9)
Central Italy	17 (6.4)
Islands or South Italy	84 (31.5)
Foreign countries	6 (2.2)
Marital status, n (%)
Married	177 (66.3)
Not married	9 (3.4)
Widow	67 (25.1)
Divorced	14 (5.2)
Level of education, n (%)
Primary school, 5 years	77 (28.8)
Secondary school, 8 years	115 (43.1)
High school diploma, 13 years	54 (20.2)
University degree, 18 years	21 (7.9)
Past job, n (%)
Manual	120 (45.0)
Nonmanual	147 (55.0)
Lifestyle, n (%)
Healthy	119 (44.6)
More or less healthy	142 (53.2)
Unhealthy	6 (2.2)
Chronic disease, n (%)
No	79 (29.6)
Yes	188 (70.4)
Life events, n (%) of yes
Loss of somebody close	64 (24.0)
Serious disease	35 (13.1)
Serious disease in somebody close	76 (28.5)
End of important relationship	10 (3.7)
Traffic accident	4 (1.5)
Crime	21 (7.9)
Satisfaction of housing environment, n (%)
No	15 (5.6)
Yes	252 (94.4)
CHS
CHS, mean (SD)	1.37 (1.0)
Frail for shrinking, n (%)	29 (10.9)
Frail for weakness, n (%)	175 (65.5)
Frail for poor endurance and energy, n (%)	69 (25.8)
Frail for slowness, n (%)	51 (19.1)
Frail for low physical activity level, n (%)	41 (15.4)
Frail individuals for CHS (≥3), n (%)	34 (12.7)
Part B of TFI
TFI, mean (SD) α =0.66	4.40 (2.56)
Physical domain	1.88 (1.61)
Psychological domain	1.47 (0.99)
Social domain	1.06 (0.91)
Frail individuals for TFI (≥5), n (%)	119 (44.6)
Other measures
IPAQ, MET-minutes/week, mean (SD)	2,085.37 (1,868.90)
CES-D, mean (SD) α =0.80	6.69 (5.34)
Loneliness, mean (SD) α =0.79	26.98 (4.50)
Outcome measures
GARS, mean (SD) α =0.90	21.19 (5.77)
≥29	27 (10.11)

Abbreviations: CHS, Cardiovascular Health Study; TFI, Tilburg Frailty Indicator; IPAQ, International Physical Activity Questionnaire; MET, metabolic equivalents of oxygen consumption; CES-D, Center of Epidemiologic Studies Depression scale, 10-item version; GARS, Groningen Activity Restriction Scale; SD, standard deviation.

Figure 1 Venn diagram of the detected frail individuals by the CHS index and the TFI.

Abbreviations: CHS, Cardiovascular Health Study; TFI, Tilburg Frailty Indicator.

Table 2 Differences in the functional status according to frailty measures

Variable	Mean (SD)	F	P-value
IPAQ (MET-minutes/week)
Robust	2,404.75 (2,125.16)	6.314	<0.001
Frail for CHS	1,177.71 (1,158.16)
Frail for TFI	2,039.01 (1,538.94)
Frail for both	834.43 (703.88)*,**
CES-D
Robust	4.09 (3.59)	34.102	<0.001
Frail for CHS	8.29 (2.43)
Frail for TFI	9.22 (5.17)*
Frail for both	11.26 (6.80)*
Loneliness
Robust	27.79 (3.60)	4.096	0.007
Frail for CHS	28.43 (2.57)
Frail for TFI	26.05 (5.43)*
Frail for both	25.56 (4.85)

Notes:

* P<0.05 if compared with robust subgroup, Sidak post hoc;

** P<0.05 if compared with frail for TFI subgroup, Sidak post hoc.

Abbreviations: IPAQ, International Physical Activity Questionnaire; MET, metabolic equivalents of oxygen consumption; CES-D, Center of Epidemiologic Studies Depression scale, 10-item version; SD, standard deviation; CHS, Cardiovascular Health Study; TFI, Tilburg Frailty Indicator.

Table 3 Relationship between uni- and multidimensional frailty measures and disability

	TFI physical	TFI psychological	TFI social	TFI	GARS
CHS	0.419*	0.369*	0.211*	0.483*	0.423*
TFI physical		0.303*	0.246*	0.837*	0.547*
TFI psychological			0.239*	0.664*	0.237*
TFI social				0.606*	0.111
TFI					0.475*

Note:

* P<0.001.

Abbreviations: CHS, Cardiovascular Health Study; TFI, Tilburg Frailty Indicator; GARS, Groningen Activity Restriction Scale.

Table 4 Criterion validity of uni- and multidimensional frailty measures for disability

	Cutoff	Outcome	Sensitivity	Specificity	AUC (SE)	CI (95%)
CHS	≥3	GARS	0.556	0.921	0.770 (0.055)	(0.663–0.877)
TFI	≥5	GARS	0.852	0.600	0.833 (0.042)	(0.752–0.915)

Abbreviations: AUC, area under the curve; SE, standard error; CI, confidence interval; CHS, Cardiovascular Health Study; TFI, Tilburg Frailty Indicator; GARS, Groningen Activity Restriction Scale.

Figure 2 ROC curves for prediction of disability with CHS index and TFI.

Note: The gray diagonal line indicates a reference AUC of 0.50 (no better than chance alone).
Abbreviations: GARS, Groningen Activity Restriction Scale; CHS, Cardiovascular Health Study; AUC, areas under the curve; TFI, Tilburg Frailty Indicator; ROC, receiver operating characteristic.