Validation of “(fr)AGILE”: a quick tool to identify multidimensional frailty in the elderly
Abstract Background Several tools have been proposed and validated to operationally define frailty. Recently, the Italian Frailty index (IFi), an Italian modified version of Frailty index, has been validated but its use in clinical practice is limited by long time of administration. Therefore, the a...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-09-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12877-020-01788-1 |
| _version_ | 1818244239115419648 |
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| author | Ilaria Liguori Gennaro Russo Giulia Bulli Francesco Curcio Veronica Flocco Gianlugi Galizia David Della-Morte Gaetano Gargiulo Gianluca Testa Francesco Cacciatore Domenico Bonaduce Pasquale Abete |
| author_facet | Ilaria Liguori Gennaro Russo Giulia Bulli Francesco Curcio Veronica Flocco Gianlugi Galizia David Della-Morte Gaetano Gargiulo Gianluca Testa Francesco Cacciatore Domenico Bonaduce Pasquale Abete |
| author_sort | Ilaria Liguori |
| collection | DOAJ |
| description | Abstract Background Several tools have been proposed and validated to operationally define frailty. Recently, the Italian Frailty index (IFi), an Italian modified version of Frailty index, has been validated but its use in clinical practice is limited by long time of administration. Therefore, the aim of this study was to create and validate a quick version of the IFi (AGILE). Methods Validation study was performed by administering IFi and AGILE, after a Comprehensive Geriatric Assessment (CGA) in 401 subjects aged 65 or over (77 ± 7 years). AGILE was a 10-items tool created starting from the more predictive items of the four domains of frailty investigated by IFi (mental, physical, socioeconomic and nutritional). AGILE scores were stratified in light, moderate and severe frailty. At 24 months of follow-up, death, disability (taking into account an increase in ADL lost ≥1 from the baseline) and hospitalization were considered. Area under curve (AUC) was evaluated for both IFi and AGILE. Results Administration time was 9.5 ± 3.8 min for IFi administered after a CGA, and 2.4 ± 1.2 min for AGILE, regardless of CGA (p < 0.001). With increasing degree of frailty, prevalence of mortality increased progressively from 6.5 to 41.8% and from 9.0 to 33.3%, disability from 16.1 to 64.2% and from 22.1 to 59.8% and hospitalization from 17.2 to 58.7% and from 27.0 to 52.2% with AGILE and IFi, respectively (p = NS). Relative Risk for each unit of increase in AGILE was 56, 44 and 24% for mortality, disability and hospitalization, respectively and was lower for IFi (8, 7 and 4% for mortality, disability and hospitalization, respectively). The AUC was higher in AGILE vs. IFi for mortality (0.729 vs. 0.698), disability (0.715 vs. 0.682) and hospitalization (0.645 vs. 0.630). Conclusions Our study shows that AGILE is a rapid and effective tool for screening multidimensional frailty, able to predict mortality, disability and hospitalization, especially useful in care settings that require reliable assessment instruments with short administration time. |
| first_indexed | 2024-12-12T14:13:51Z |
| format | Article |
| id | doaj.art-ff1027f524684989af5a1618f698e489 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-12T14:13:51Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-ff1027f524684989af5a1618f698e4892022-12-22T00:21:59ZengBMCBMC Geriatrics1471-23182020-09-0120111010.1186/s12877-020-01788-1Validation of “(fr)AGILE”: a quick tool to identify multidimensional frailty in the elderlyIlaria Liguori0Gennaro Russo1Giulia Bulli2Francesco Curcio3Veronica Flocco4Gianlugi Galizia5David Della-Morte6Gaetano Gargiulo7Gianluca Testa8Francesco Cacciatore9Domenico Bonaduce10Pasquale Abete11Department of Translational Medical Sciences, University of Naples “Federico II”Department of Translational Medical Sciences, University of Naples “Federico II”Department of Translational Medical Sciences, University of Naples “Federico II”Department of Translational Medical Sciences, University of Naples “Federico II”Department of Translational Medical Sciences, University of Naples “Federico II”Department of Translational Medical Sciences, University of Naples “Federico II”Department of Systems Medicine, University of Rome Tor VergataDivision of Internal Medicine, AOU San Giovanni di Dio e Ruggi di AragonaDepartment of Translational Medical Sciences, University of Naples “Federico II”Department of Translational Medical Sciences, University of Naples “Federico II”Department of Translational Medical Sciences, University of Naples “Federico II”Department of Translational Medical Sciences, University of Naples “Federico II”Abstract Background Several tools have been proposed and validated to operationally define frailty. Recently, the Italian Frailty index (IFi), an Italian modified version of Frailty index, has been validated but its use in clinical practice is limited by long time of administration. Therefore, the aim of this study was to create and validate a quick version of the IFi (AGILE). Methods Validation study was performed by administering IFi and AGILE, after a Comprehensive Geriatric Assessment (CGA) in 401 subjects aged 65 or over (77 ± 7 years). AGILE was a 10-items tool created starting from the more predictive items of the four domains of frailty investigated by IFi (mental, physical, socioeconomic and nutritional). AGILE scores were stratified in light, moderate and severe frailty. At 24 months of follow-up, death, disability (taking into account an increase in ADL lost ≥1 from the baseline) and hospitalization were considered. Area under curve (AUC) was evaluated for both IFi and AGILE. Results Administration time was 9.5 ± 3.8 min for IFi administered after a CGA, and 2.4 ± 1.2 min for AGILE, regardless of CGA (p < 0.001). With increasing degree of frailty, prevalence of mortality increased progressively from 6.5 to 41.8% and from 9.0 to 33.3%, disability from 16.1 to 64.2% and from 22.1 to 59.8% and hospitalization from 17.2 to 58.7% and from 27.0 to 52.2% with AGILE and IFi, respectively (p = NS). Relative Risk for each unit of increase in AGILE was 56, 44 and 24% for mortality, disability and hospitalization, respectively and was lower for IFi (8, 7 and 4% for mortality, disability and hospitalization, respectively). The AUC was higher in AGILE vs. IFi for mortality (0.729 vs. 0.698), disability (0.715 vs. 0.682) and hospitalization (0.645 vs. 0.630). Conclusions Our study shows that AGILE is a rapid and effective tool for screening multidimensional frailty, able to predict mortality, disability and hospitalization, especially useful in care settings that require reliable assessment instruments with short administration time.http://link.springer.com/article/10.1186/s12877-020-01788-1FrailtyMultidimensionalComprehensive geriatric assessment |
| spellingShingle | Ilaria Liguori Gennaro Russo Giulia Bulli Francesco Curcio Veronica Flocco Gianlugi Galizia David Della-Morte Gaetano Gargiulo Gianluca Testa Francesco Cacciatore Domenico Bonaduce Pasquale Abete Validation of “(fr)AGILE”: a quick tool to identify multidimensional frailty in the elderly BMC Geriatrics Frailty Multidimensional Comprehensive geriatric assessment |
| title | Validation of “(fr)AGILE”: a quick tool to identify multidimensional frailty in the elderly |
| title_full | Validation of “(fr)AGILE”: a quick tool to identify multidimensional frailty in the elderly |
| title_fullStr | Validation of “(fr)AGILE”: a quick tool to identify multidimensional frailty in the elderly |
| title_full_unstemmed | Validation of “(fr)AGILE”: a quick tool to identify multidimensional frailty in the elderly |
| title_short | Validation of “(fr)AGILE”: a quick tool to identify multidimensional frailty in the elderly |
| title_sort | validation of fr agile a quick tool to identify multidimensional frailty in the elderly |
| topic | Frailty Multidimensional Comprehensive geriatric assessment |
| url | http://link.springer.com/article/10.1186/s12877-020-01788-1 |
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