@article{ba105abbad7c453e882cd5fa876211b8,
title = "Development, construct validity, and predictive validity of a continuous frailty scale: Results from 2 large US cohorts",
abstract = "Frailty is an age-related clinical syndrome of decreased resilience to stressors. Among numerous assessments of frailty, the frailty phenotype (FP) scale proposed by Fried et al. has been the most widely used. We aimed to develop a continuous frailty scale that could overcome limitations facing the categorical FP scale and to evaluate its construct validity, predictive validity, and measurement properties. Data were from the Cardiovascular Health Study (n = 4,243) and Health and Retirement Study (n = 7,600), both conducted in the United States. Frailty was conceptualized as a continuous construct, assessed by 5 measures used in the FP scale: gait speed, grip strength, exhaustion, physical activity, and weight loss. We used confirmatory factor analysis to investigate the relationship between the 5 indicators and the latent frailty construct. We examined the association of the continuous frailty scale with mortality and disability. The unidimensional model fit the data satisfactorily; similar factor structure was observed across 2 cohorts. Gait speed and weight loss were the strongest and weakest indicators, respectively; grip strength, exhaustion, and physical activity had similar strength in measuring frailty. In each cohort, the continuous frailty scale was strongly associated with mortality and disability and continued to be associated with outcomes among robust and prefrail persons classified by the FP scale.",
keywords = "Confirmatory factor analysis, Construct validity, Frailty, Older adults, Predictive validity",
author = "Chenkai Wu and Geldhof, {G. John} and Xue, {Qian Li} and Kim, {Dae H.} and Newman, {Anne B.} and Odden, {Michelle C.}",
note = "Funding Information: This research was supported by the National Heart, Lung, and Blood Institute, with additional contribution from the National Institute of Neurological Disorders and Stroke (contracts HHSN268201200036C, HHSN268200800007C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, and grants U01HL080295 and U01HL130114). Additional support was provided by the National Institute on Aging (grants R01AG023629 (M.C.O.), R03AG048541 (Q.-L.X.), K08AG051187 (D.H.K.), and P30AG013679 (D.H.K.)). D. H.K. is supported by the American Federation for Aging Research, the John A. Hartford Foundation, and the Atlantic Philanthropies. A full list of principal Cardiovascular Health Study investigators and institutions can be found at CHS-NHLBI.org. D.H.K. provides paid consultative services to Alosa Health, a nonprofit educational organization with no relationship to any drug or device manufacturers. Funding Information: This research was supported by the National Heart, Lung, and Blood Institute, with additional contribution from the National Institute of Neurological Disorders and Stroke (contracts HHSN268201200036C, HHSN268200800007C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, and grants U01HL080295 and U01HL130114). Additional support was provided by the National Institute on Aging (grants R01AG023629 (M.C.O.), R03AG048541 (Q.-L.X.), K08AG051187 (D.H.K.), and P30AG013679 (D.H.K.)). D. H.K. is supported by the American Federation for Aging Research, the John A. Hartford Foundation, and the Atlantic Philanthropies. A full list of principal Cardiovascular Health Study investigators and institutions can be found at CHSNHLBI.org. Publisher Copyright: {\textcopyright} 2018 Frontiers Media S.A. All Rights Reserved.",
year = "2018",
month = aug,
day = "1",
doi = "10.1093/aje/kwy041",
language = "English (US)",
volume = "187",
pages = "1752--1762",
journal = "American journal of epidemiology",
issn = "0002-9262",
publisher = "Oxford University Press",
number = "8",
}