@article{067b9b98fb43453a8d8d987c8792ceb0,
title = "Agreement between 35 published frailty scores in the general population",
abstract = "In elderly populations, frailty is associated with higher mortality risk. Although many frailty scores (FS) have been proposed, no single score is considered the gold standard. We aimed to evaluate the agreement between a wide range of FS in the English Longitudinal Study of Ageing (ELSA). Through a literature search, we identified 35 FS that could be calculated in ELSA wave 2 (2004-2005). We examined agreement between each frailty score and the mean of 35 FS, using a modified Bland-Altman model and Cohen's kappa (κ). Missing data were imputed. Data from 5,377 participants (ages ≥60 years) were analyzed (44.7% men, 55.3% women). FS showed widely differing degrees of agreement with the mean of all scores and between each pair of scores. Frailty classification also showed a very wide range of agreement (Cohen's κ = 0.10-0.83). Agreement was highest among {"}accumulation of deficits{"}-type FS, while accuracy was highest for multidimensional FS. There is marked heterogeneity in the degree to which various FS estimate frailty and in the identification of particular individuals as frail. Different FS are based on different concepts of frailty, and most pairs cannot be assumed to be interchangeable. Research results based on different FS cannot be compared or pooled.",
keywords = "Bland-Altman model, Cohen's kappa coefficient, accuracy, agreement, disability, elderly population, frailty scores, reliability",
author = "Aguayo, {Gloria A.} and Donneau, {Anne Fran{\c c}oise} and Vaillant, {Michel T.} and Anna Schritz and Franco, {Oscar H.} and Saverio Stranges and Laurent Malisoux and Mich{\`e}le Guillaume and Witte, {Daniel R.}",
note = "Funding Information: Preliminary results of this study were presented at the 50th meeting of the European Diabetes Epidemiology Group, Chantilly, France, April 25–28, 2015, and at the “Methods in Epidemiology” symposium organized by the Epidemiology Research Group at the University of Leuven, Leuven, Belgium, September 17, 2015. The data used in this analysis were made available through the United Kingdom Data Archive and were accessed via the UK Data Service (data-sharing project 82538) (13). The English Longitudinal Study of Ageing (ELSA) was initiated by a team of researchers based at NatCen Social Research, University College London, and the Institute for Fiscal Studies. The data were collected by NatCen Social Research. Funding for ELSA is provided by the US National Institute of Aging and a consortium of United Kingdom government departments coordinated by the Office for National Statistics. The developers and funders of ELSA and the United Kingdom Data Archive do not bear any responsibility for the analyses or interpretations presented here. Conflict of interest: none declared. Funding Information: Author affiliations: Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg (Gloria A. Aguayo, Saverio Stranges, Laurent Malisoux); Department of Public Health Sciences, Faculty of Medicine, University of Li{\`e}ge, Li{\`e}ge, Belgium (Anne-Fran{\c c}oise Donneau, Mich{\`e}le Guillaume); Competence Center for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg (Michel T. Vaillant, Anna Schritz); Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (Oscar H. Franco); Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark (Daniel R. Witte); and Danish Diabetes Academy, Odense University Hospital, Odense, Denmark (Daniel R. Witte). This work was supported by the Ministry of Higher Education and Research of Luxembourg. Publisher Copyright: {\textcopyright} The Author(s) 2017.",
year = "2017",
month = aug,
day = "15",
doi = "10.1093/aje/kwx061",
language = "English",
volume = "186",
pages = "420--434",
journal = "American Journal of Epidemiology",
issn = "0002-9262",
publisher = "Oxford University Press",
number = "4",
}