Background
Methods
Search strategy, selection criteria and data extraction
Psychometric properties– definitions
Quality assessment
Registration
Funding
Results
Search results
Description of study characteristics
Study
|
Design data set
|
Total N (% women)
|
Follow-up (LTFU)
|
FI deficits
|
FI scores
| |||
---|---|---|---|---|---|---|---|---|
Mean age (yrs ± SD)
|
Deficit number
|
Deficit scoring
|
Deficit weighting
|
Mean/Median(± SD/IQR) |
Range
| |||
Setting
| ||||||||
Armstrong et al. [21] | Retrospective cohort study | 23,952 (69.4%) | 1 yr (?) | 50 | B | No | ? | ? – 0.66 |
81.7 (± 7.4) | ||||||||
8 CCACs | Home-care clients | |||||||
Cigolle et al. [20] | Cross-sectional study | 1,657 (55.5%) | N/A | 38 | ? | ? | ? | ? |
? | ||||||||
HRS | Community-dwelling | |||||||
Drubbel et al. [22] | Retrospective cohort study | 1,679 (59%) | 2 yrs (10.5%) | 36 | B | No | 0.08 (0.03-0.14) | 0 – 0.42 |
Median 73 (IQR 65–81) | ||||||||
GPs EMRs | Community-dwelling | |||||||
Fang et al. [32] | Retrospective cohort study | 3,257 (51.1%) | 8 yrs (13.8%) | 33 | B/M | No | 0.13 (± ?) | 0 – 0.67 |
70.1 (± 9.0) | ||||||||
BLSA | Community-dwelling | |||||||
García-González et al. [33] | Retrospective | Total sample: 4,872 | 1.95 yrs (13.2%) | 34 | B/M | No | 0.16 (± 0.11) | 0 – 0.65 |
cohort study | Analyzed sample: | |||||||
MHAS | 4,082 (52.5%) | |||||||
73 (range 65–105) | ||||||||
Community-dwelling | ||||||||
Gu et al. [23] | Retrospective cohort study | 13,861 (57.2%) | 3 yrs (12.9%) | 39 | B | Yes | 0.26 (± ?) | ? |
? (range 65–109) | ||||||||
CLHLS | Population-based | |||||||
Hogan et al. [37] | Retrospective cohort study | 1,066 (76.7%) | 1 yr (0%) | 83a
| B/M | No | ? | ? |
84.9 (± 7.3) | ||||||||
ACCES | Assisted living residents | |||||||
Kulminski et al. [24] | Retrospective cohort study | 4,721 (?%) | 4 yrs (0%) | 48 | B | No | ? | 0 – 0.70 |
? | ||||||||
CHS | Population-based | |||||||
Kulminski et al. [25] | Retrospective cohort study | 24,206 (65.9%) | 4 yrs (?) | 32 | B | No | 0.25 (± ?) | 0 – 0.70 |
78.3 (± ?) | ||||||||
NLTCS | Population-based | |||||||
Lucicesare et al. [27] | Prospective cohort study | 1,016 (55.4%) | 4 yrs (0%) | 43 | B | No | 0.14 (± ?) | 0 – 0.70 |
74.7 (± 7.1) | ||||||||
CSBA | Population –based | |||||||
Lucicesare et al. [28] | Retrospective cohort study | 1,318 (63.1%) | 5 yrs (?) | 38 | ? | ? | ? | 0 – 0.59 |
76.05 (± ?) | ||||||||
CSHA | Population-based | |||||||
Mitnitski et al. [34] | Retrospective cohort study NPHS, CSHA (3), ALSA, SOPSA, NHANES, H-70, NLTCS-I, ICONS, BCS | 36,424 (58.5%) | 3-12 yrs (?) | 10 FI’s: 38-40 | B/M | No | ? | ? |
74 (range: 27 – 105) | ||||||||
7 community-dwelling and 4 clinical/institutional samples | 1 FI: 13 | |||||||
Mitnitski et al. [6] | Retrospective cohort study | 2,913 (?%) | 5 yrs (?) | 92 | B | No | ? | ? |
82 (± 7.4) | ||||||||
CSHA | Population-based | |||||||
Rockwood et al. [28] | Retrospective cohort study | 2,305 (?%) | 5 yrs (?) | 70 | B/M | No | ? | 0 – 0.70 |
? | ? | |||||||
CSHA | Population-based | |||||||
Searle et al. [9] | Retrospective cohort study | 754 (64.6%) | 9 yrs (<10%) | 40 | B/M | No | ? | 0 – 0.60 |
? | ||||||||
YPEP | Community-dwelling | |||||||
Shi et al. [35] | Retrospective cohort study | 3,257 ((51.1%) | 8 yrs (12.2%) | 35 | B/M | No | ? | ? – 0.70 |
70.1 (± 9.0) | ||||||||
BLSA | Community-dwelling | |||||||
Song et al. [29] | Retrospective cohort study | 2,740 (60.8%) | 10 yrs (10.1%) | 36 | B | No | 0.15 (± ?) | 0 – 0.70 |
74 (± 6.6) | ||||||||
NPHS | Population-based | |||||||
Theou et al. [36] | Retrospective cohort study | 2,305 (62.1%) | 5 yrs (?) | FI 1: 37b
| B/M | No | FI 2: 0.24 (± 0.15) | 0 – 0.68 |
84.6 (± 7.0) | FI 2: 37c
| |||||||
CSHA | Community-dwelling | |||||||
Woo et al. [30] | Prospective cohort study | 4,000 (50%) | 4 yrs (15.9%) | 47 | B | No | ? | ? |
? | ||||||||
CUHKS | Community-dwelling | |||||||
Woo et al. [31] | Retrospective cohort study | 2,032 (50.8%) | 10 yrs | 62 | B | Yes | 0.13 (?) | 0 – 0.53 |
? | 42.4% (3 yrs) | |||||||
HKHS | Population-based | 85.3% (10 yrs) |
Quality assessment
Study
|
Study participation
|
Study attrition
|
Prognostic factor measurement
|
Outcome measurement
|
Statistical analysis
|
---|---|---|---|---|---|
Armstrong et al. [21] | Low | Low | Low | Moderate | Low |
Cigolle et al. [20] | Low | N/A | Moderate | Low | Moderate |
Drubbel et al. [22] | Low | Moderate | Moderate | Low | Low |
Fang et al. [32] | Low | Moderate | Moderate | Low | Low |
García-González et al. [33] | Low | Moderate | Low | Low | Low |
Gu et al. [23] | Low | Low | Low | Low | Low |
Hogan et al. [37] | Low | Low | Low | Low | Low |
Kulminski et al. [24] | Moderate | Low | Moderate | Low | Low |
Kulminski et al. [25] | Low | High | Low | Low | Low |
Lucicesare et al. [26] | Low | Low | Moderate | Low | Moderate |
Lucicesare et al. [27] | Low | N/Aa
| Moderate | Low | Low |
Mitnitski et al. [34] | Low | High | Moderate | Low | Low |
Mitnitski et al. [6] | Low | Moderate | Low | Low | Low |
Rockwood et al. [28] | Moderate | Moderate | Low | Low | Low |
Searle et al. [19] | Low | High | Moderate | Low | Low |
Shi et al. [35] | Low | Low | Low | Low | Low |
Song et al. [29] | Low | Low | Low | Low | Low |
Theou et al. [36] | Low | Moderate | Moderate | Low | Moderate |
Woo et al. [30] | High | Moderate | Moderate | Low | Moderate |
Woo et al. [31] | Low | High | Moderate | Low | Low |
Psychometric properties of the FI
Criterion validity
Study
|
Outcome variable with events (n)
|
Model
|
Factors controlled for in model
|
Effect measure
|
95% CI/SE
|
Interpretation effect measure
|
---|---|---|---|---|---|---|
Armstrong et al. [21] | Mortality: 1676 | Cox proportional hazards regression | Age, gender | FI: HR = 1.93 | 1.79-2.08 | Most frail (15%) vs. least frail (60%) group |
Institutionalization: 4550 | (EFS: HR = 2.49) | (2.32-2.68) | ||||
(CHESS: HR = 2.32) | (2.15-2.51) | |||||
Drubbel et al. [22] | Mortality/ED visits/institutionalization/out-of-hours GP surgery visits: 508 | Cox proportional hazards regression | Age, gender, consultation gap | HR = 1.166 | 1.129-1.210 | Per deficit increase in FI score |
Fang et al. [32] | Recurrent falls: 109 | Logistic regression | Age, gender, education | OR = 1.54 | 1.34-1.76 | Per one-unit increment in FI score |
Recurrent fractures: 174 | Logistic regression | Age, gender, education | OR = 1.07 | 0.94-1.22 | Per one-unitincrement in FI score | |
Mortality: 1101 | Cox proportional hazards regression | Age, gender, education, falls, fractures | HR = 1.29 | 1.25-1.33 | Per one-unit increment FI score | |
García-González et al. [33] | Mortality: 279 | Cox proportional hazards regression | Age, gender | HR = 6.45 | 4.10-10.14 | Most frail (FI 0.35-0.65) vs. least frail group (0.00-0.07) |
Gu et al. [23] | Mortality: 5,753 | Weibull proportional hazards regression | Age, ethnicity, urban–rural residence, SES, family/social connection and support, health practices | Men (65–79): | Most frail vs. least frail quartile | |
HR = 4.56 | 0.96 | |||||
Women (65–79): | ||||||
HR = 3.84 | 1.01 | |||||
Hogan et al. [37] | Mortality: 170 | Logistic regression | Age, gender, co-morbidity | RR = 2.35 | 1.56-3.54 | All analyses: most frail (FI > 0.30) vs. least frail group (FI < 0.20) |
≥ 1 hospitalization: 424 | Logistic regression | Age, gender, co-morbidity | RR = 1.28 | 1.04-1.57 | ||
Institutionalization: 204 | Logistic regression | Age, gender, co-morbidity | RR = 3.30 | 2.29-4.76 | ||
Kulminski et al. [24] | Mortality: 421 | Cox proportional hazards regression | Age, gender, FP | FI: RR = 1.035 | 1.026-1.045 | |
(FP: RR = 1.014) | (1.009-1.019) | Per 1% increment in FI score (or FP) | ||||
Kulminski et al. [25] | Mortality: 2146 | Cox proportional hazards regression | Age, gender | RR = 1.029 | 1.001 | Per 1% increment in FI score |
Lucicesare et al. [26] | Mortality: 147 | Cox proportional hazards regression | Age, gender, CSBA score | FI: HR = 5.26 | 1.05-26.42 | ? |
(CSBA score: HR = 1.52) | (1.28-1.81) | |||||
Mitnitski et al. [34] | Mortality (%/yr) 3.7-20.6 | Cox proportional hazards regression | Age, gender | CSHA-s: HR = 1.031 | 0.003 | Per deficit increase in FI score |
CSHA-c: HR = 1.054 | 0.007 | |||||
CSHA-i: HR = 1.046 | 0.009 | |||||
SOPSA: HR =1.079 | 0.022 | |||||
NHANES: HR = 1.011 | 0.003 | |||||
Searle et al. [19] | Mortality: ? | Cox proportional hazards regression | Age, gender | HR = 1.03 | 1.02-1.04 | Per 0.01 increase in FI score |
Shi et al. [35] | Mortality: 1,155 | Cox proportional hazards regression | Age, gender | HR = 1.13 | 1.09-1.47 | Per deficit increase in FI score |
Song et al. [29] | Mortality: 1,208 | Cox proportional hazards regression | Age, gender | FI: RR = 1.57 | 1.41-1.74 | Per FI level (FI ≤ 0.08; FI between 0.08-0.25; FI ≥ 0.25). |
Theou et al. [36] | Mortality: 1002 | Cox proportional hazards regression | Age, gender, nr. of ADL disabilities, nr. of chronic diseases | FI 1: HR = 1.11 | 1.06-1.17 | Per 0.1 increase in FI score |
Woo et al. [31] | Change in ADL score 0–3 yrsa
| Linear regression | Age, gender, ADL score at baseline | B = −4.99 | −7.68 - −2.30 | Per 1.0 increase in FI score |
Change in mental score 0-3 yrsa
| Linear regression | Age, gender, mental score at baseline | B = −2.23 | −4.11 - −0.35 | Per 1.0 increase in FI score | |
Change in hospital days 0–3 yrsa
| Linear regression | Age, gender, hospital days at baseline | B = 45.74 | 28.16 – 63.33 | Per 1.0 increase in FI score | |
New diseases at three yrsa
| Ordinal logistic regression | - | For FI = 0.00, predicted probability ≥ 1 new disease = 17.4% | Predicted probabilities for new diseases at 3 years | ||
For FI = 0.50, predicted probability ≥ 1 new disease = 52.2% |