1. Assessing Global Frailty Scores: Development of a Global Burden of Disease-Frailty Index (GBD-FI)
- Author
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Zubair Kabir, Aaron Liew, Mark O'Donovan, Duygu Sezgin, and Rónán O'Caoimh
- Subjects
China ,medicine.medical_specialty ,Index (economics) ,Health, Toxicology and Mutagenesis ,Population ,lcsh:Medicine ,frailty ,Global Health ,Article ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Linear regression ,parasitic diseases ,Content validity ,Humans ,Medicine ,030212 general & internal medicine ,education ,Face validity ,education.field_of_study ,global burden of disease ,business.industry ,Public health ,public health ,lcsh:R ,Public Health, Environmental and Occupational Health ,other ,Reproducibility of Results ,Construct validity ,humanities ,Female ,Metric (unit) ,business ,030217 neurology & neurosurgery ,Demography - Abstract
Frailty is an independent age-associated predictor of morbidity and mortality. Despite this, many countries lack population estimates with large heterogeneity between studies. No population-based standardised metric for frailty is available. We applied the deficit accumulation model of frailty to create a frailty index (FI) using population-level estimates from the Global Burden of Disease (GBD) 2017 study across 195 countries to create a novel GBD frailty index (GBD-FI). Standard FI criteria were applied to all GBD categories to select GBD-FI items. Content validity was assessed by comparing the GBD-FI with a selection of established FIs. Properties including the rate of deficit accumulation with age were examined to assess construct validity. Linear regression models were created to assess if mean GBD-FI scores predicted one-year incident mortality. From all 554 GBD items, 36 were selected for the GBD-FI. Face validity against established FIs was variable. Characteristic properties of a FI&mdash, higher mean score for females and a deficit accumulation rate of approximately 0.03 per year, were observed. GBD-FI items were responsible for 19% of total Disability-Adjusted Life Years for those aged &ge, 70 years in 2017. Country-specific mean GBD-FI scores ranged from 0.14 (China) to 0.19 (Hungary) and were a better predictor of mortality from non-communicable diseases than age, gender, Healthcare Access and Quality Index or Socio-Demographic Index scores. The GBD-FI is a valid measure of frailty at population-level but further external validation is required.
- Published
- 2020