背景:已经开发了几种经过验证的量表来测量脆弱,然而,这些措施和他们的分数之间的直接关系仍然未知。为了弥合这个差距,我们创造了一个最常用的脆弱尺度的人行横道。
方法:我们使用来自参加国家健康和老龄化趋势研究(NHATS)第5轮的7070名社区居住的老年人的数据,在脆弱的尺度中构建了一条人行横道。我们实施了骨质疏松性骨折指数(SOF)的研究,FRAILScale,脆弱表型,临床虚弱量表(CFS),脆弱老年人调查-13(VES-13),蒂尔堡脆弱指标(TFI),格罗宁根脆弱指示器(GFI),埃德蒙顿脆弱量表(EFS),和40项脆弱指数(FI)。使用等百分位链接方法创建FI和脆弱量表之间的人行横道,一种统计程序,根据百分位分布在量表之间产生相等的评分。为了证明其有效性,我们确定了低风险(相当于FI<0.20)的所有量表的4年死亡风险,中等风险(FI0.20至<0.40),和高风险(FI≥0.40)类别。
结果:使用NHATS,计算所有九种量表的脆弱分数的可行性至少为90%,FI具有最高数量的可计算分数。参与者认为FI上的虚弱(切点为0.25)对应于每个虚弱指标的以下得分:SOF1.3,FRAIL1.7,表型1.7,CFS5.3,VES-135.5,TFI4.4,GFI4.8和EFS5.8。相反,根据每个虚弱测量的切点认为虚弱的个体对应于以下FI分数:SOF为0.37,FRAIL为0.40,表型为0.42,CFS为0.21,VES-13为0.16,TFI为0.28,GFI为0.21,EFS为0.37。在脆弱的天平上,相同类别之间的4年死亡风险在大小上相似.
结论:我们的研究结果为临床医生和研究人员提供了一个有用的工具来直接比较和解释不同量表的脆弱评分。
Several validated scales have been developed to measure frailty, yet the direct relationship between these measures and their scores remains unknown. To bridge this gap, we created a crosswalk of the most commonly used frailty scales.
We used data from 7070 community-dwelling older adults who participated in National Health and Aging Trends Study (NHATS) Round 5 to construct a crosswalk among frailty scales. We operationalized the Study of Osteoporotic Fracture Index (SOF), FRAIL Scale, Frailty Phenotype, Clinical Frailty Scale (CFS), Vulnerable Elder Survey-13 (VES-13), Tilburg Frailty Indictor (TFI), Groningen Frailty Indicator (GFI), Edmonton Frailty Scale (EFS), and 40-item Frailty Index (FI). A crosswalk between FI and the frailty scales was created using the equipercentile
linking method, a statistical procedure that produces equivalent scoring between scales according to percentile distributions. To demonstrate its validity, we determined the 4-year mortality risk across all scales for low-risk (equivalent to FI <0.20), moderate-risk (FI 0.20 to <0.40), and high-risk (FI ≥0.40) categories.
Using NHATS, the feasibility of calculating frailty scores was at least 90% for all nine scales, with the FI having the highest number of calculable scores. Participants considered frail on FI (cutpoint of 0.25) corresponded to the following scores on each frailty measure: SOF 1.3, FRAIL 1.7, Phenotype 1.7, CFS 5.3, VES-13 5.5, TFI 4.4, GFI 4.8, and EFS 5.8. Conversely, individuals considered frail according to the cutpoint of each frailty measure corresponded to the following FI scores: 0.37 for SOF, 0.40 for FRAIL, 0.42 for Phenotype, 0.21 for CFS, 0.16 for VES-13, 0.28 for TFI, 0.21 for GFI, and 0.37 for EFS. Across frailty scales, the 4-year mortality risks between the same categories were similar in magnitude.
Our results provide clinicians and researchers with a useful tool to directly compare and interpret frailty scores across scales.