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Can the Combined Use of Two Screening Instruments Improve the Predictive Power of Dependency in (Instrumental) Activities of Daily Living, Mortality and Hospitalization in Old Age?
- Source :
- The Journal of Frailty & Aging, 8(4), 180-185. Serdi Publishing Company, The Journal of Frailty & Aging, 8(4), Op Het Veld, L P M, van Rossum, E, Kempen, G I J M, Beurskens, A J H M, Hajema, K J & de Vet, H C W 2019, ' Can the Combined Use of Two Screening Instruments Improve the Predictive Power of Dependency in (Instrumental) Activities of Daily Living, Mortality and Hospitalization in Old Age? ', The Journal of Frailty & Aging, vol. 8, no. 4, pp. 180-185 . https://doi.org/10.14283/jfa.2019.17
- Publication Year :
- 2019
-
Abstract
- Background: Due to differences in the definition of frailty, many different screening instruments have been developed. However, the predictive validity of these instruments among community-dwelling older people remains uncertain. Objective: To investigate whether combined (i.e. sequential or parallel) use of available frailty instruments improves the predictive power of dependency in (instrumental) activities of daily living ((I)ADL), mortality and hospitalization. Design, setting and participants: A prospective cohort study with two-year follow-up was conducted among pre-frail and frail community-dwelling older people in the Netherlands. Measurements: Four combinations of two highly specific frailty instruments (Frailty Phenotype, Frailty Index) and two highly sensitive instruments (Tilburg Frailty Indicator, Groningen Frailty Indicator) were investigated. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for all single instruments as well as for the four combinations, sequential and parallel. Results: 2,420 individuals participated (mean age 76.3 ± 6.6 years, 60.5% female) in our study. Sequential use increased the levels of specificity, as expected, whereas the PPV hardly increased. Parallel use increased the levels of sensitivity, although the NPV hardly increased. Conclusions: Applying two frailty instruments sequential or parallel might not be a solution for achieving better predictions of frailty in community-dwelling older people. Our results show that the combination of different screening instruments does not improve predictive validity. However, as this is one of the first studies to investigate the combined use of screening instruments, we recommend further exploration of other combinations of instruments among other study populations.
- Subjects :
- Male
Predictive validity
Gerontology
Activities of daily living
frailty (instruments)
Frail Elderly
Combined use
Frailty Index
frailty
PHENOTYPE
03 medical and health sciences
screening instruments
0302 clinical medicine
Predictive Value of Tests
PEOPLE
activities of daily living (adl)
Activities of Daily Living
Humans
Medicine
Prospective Studies
030212 general & internal medicine
VALIDITY
Prospective cohort study
Groningen Frailty Indicator
Geriatric Assessment
Aged
Netherlands
Aged, 80 and over
MEASURING FRAILTY
OUTCOMES
business.industry
screening
DISABILITY
General Medicine
ADULTS
mortality
Highly sensitive
combined use
predictive validity
sensitivity and specificity
Frail older people
Predictive power
Female
business
030217 neurology & neurosurgery
hospitalization
Subjects
Details
- Language :
- English
- ISSN :
- 22601341
- Volume :
- 8
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- The Journal of Frailty & Aging
- Accession number :
- edsair.doi.dedup.....f6448be4ed7c5270b049d975a923b353