Beyond the Health Deficit Count: Examining Deficit Patterns in a Deficit‐Accumulation Frailty Index. Issue 3 (25th November 2020) - Olivieri‐Mui, Brianne L.
Abstract : Background/Objectives: Exploring deficit patterns among frail people may reveal subgroups of different prognostic importance. Design: Analysis of National Health and Aging Trends Study. Setting: Community. Participants: Community dwelling older adults with mild to moderate frailty (deficit‐accumulation frailty index (FI) of 0.25–0.40) (n = 1821). Measurements: Latent class analysis identified distinct clinical subgroups based on comorbidity (range: 0–10), National Health and Aging Trends Study dementia classification, and short physical performance battery (SPPB) (range: 0–12). Survival analyses compared 5‐year mortality by subgroups. Results: Three latent classes existed: Class 1 (n = 831, mean FI = 0.30) had 2.7% probable dementia, high comorbidities (mean = 3.6), and low physical impairment (SPPB mean = 9.9); Class 2 (n = 734, mean FI = 0.32) had 6.9% probable dementia, low comorbidities (mean = 2.8), and moderate physical impairment (SPPB mean = 6.2); Class 3 (n = 256, mean FI = 0.34) had 20.7% probable dementia, low comorbidities (mean = 2.4), and high physical impairment (SPPB mean = 2.0). Compared to Class 1, Classes 2 and 3 experienced higher 5‐year mortality (C2: 1.28 (95% confidence intervals (CI) = 1.00–1.62); C3: 1.87 (95% CI = 1.29–2.73)). Conclusion: Deficit patterns among the mild‐to‐moderately frail provide additional prognostic information and highlight opportunities for preventive interventions.