Validation of the Modified Frailty Phenotype Measure in Older Mexican Americans - American Geriatric Society

OBJECTIVES

Develop and validate a modified frailty phenotype measure for older Mexican Americans participating in the Hispanic Established Populations for the Epidemiological Study of the Elderly (H‐EPESE) and related studies.

DESIGN

Expert‐based panel evaluation of content validity, cross‐sectional analysis of construct validity, and longitudinal analysis of criterion validity for a modified version of the frailty phenotype measure.

SETTING

Five southwestern states.

PARTICIPANTS

A total of 1833 community‐dwelling Mexican Americans aged 67 years or older.

MEASUREMENTS

Frailty was assessed using the frailty phenotype measure (weight loss, weakness, exhaustion, slowness, and low physical activity) and a modified frailty phenotype measure (replacing “low physical activity” with “limitations in walking half a mile”). Each individual was classified as non‐frail, pre‐frail, or frail based on both frailty measures (original vs modified). Expert panel consensus was used to examine content validity. Spearman correlation, κ, weighted κ, and bootstrapping κ examined construct validity (n = 1833). Generalized linear mixed models, odds ratios, Cox proportional regression models, hazard ratios, and C statistics were used to analyze criterion validity (n = 1446) across four outcomes: hospitalization, physician visits, disability, and mortality from wave 3 (1998‐99) through wave 8 (2012‐13).

RESULTS

The original and modified frailty phenotype measures had a strong correlation (r = .89; P < .000) and agreement (κ = .84; 95% confidence interval [CI] = .81‐.86; weighted κ = .86; 95% CI = .84‐.88; bootstrap κ = .84; 95% CI = .81‐.86; bootstrap‐weighted κ = .86; 95% CI = .84‐.88 with 1000 bootstrapping samples). Four outcome models showed similar risk predictions for both frailty measures, with the exception of physician visits for frail participants.

CONCLUSION

“Limitations in walking half a mile” can be used as a substitute criterion for “low physical activity” in assessing frailty. The modified frailty phenotype measure was comparable with the original frailty phenotype measure in H‐EPESE participants over time. Our results indicate the modified frailty phenotype is a useful longitudinally frailty measure for community‐dwelling older Mexican Americans.

from Wiley: Journal of the American Geriatrics Society: Table of Contents https://ift.tt/2Z8FUWS
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