Validity Properties of a Self-reported Modified Frailty Phenotype Among People With HIV in Clinical Care in the United States. (18th March 2023)

• Record Type: Journal Article
• Authors: Ruderman, Stephanie A.; Webel, Allison R.; Willig, Amanda L.; Drumright, Lydia N.; Fitzpatrick, Annette L.; Odden, Michelle C.; Cleveland, John D.; Burkholder, Greer; Davey, Christine H.; Fleming, Julia; Buford, Thomas W.; Jones, Raymond; Nance, Robin M.; Whitney, Bridget M.; Mixson, L. Sarah; Hahn, Andrew W.; Mayer, Kenneth H.; Greene, Meredith; Saag, Michael S.; Kamen, Charles; Pandya, Chintan; Lober, William B.; Kitahata, Mari M.; Crane, Paul K.; Crane, Heidi M.; Delaney, Joseph A. C.
• Is Part Of: Journal of the Association of Nurses in AIDS Care. Volume 34:Number 2(2023)
• Page Start: 158
• Page End: 170
• Publication Date: 2023-03-18
• Subjects: frailty phenotype -- feasibility -- HIV and aging -- people with HIV -- validity; AIDS (Disease) -- Nursing -- Periodicals; AIDS (Disease) -- Treatment -- Periodicals; AIDS (Disease) -- Periodicals; HIV infections -- Nursing -- Periodicals; HIV infections -- Treatment -- Periodicals; HIV infections -- Periodicals; 616.97920231
• DOI: 10.1097/JNC.0000000000000389
• Languages: English
• ISSNs: 1055-3290

Abstract

Abstract: Modifications to Fried's frailty phenotype (FFP) are common. We evaluated a self-reported modified frailty phenotype (Mod-FP) used among people with HIV (PWH). Among 522 PWH engaged in two longitudinal studies, we assessed validity of the four-item Mod-FP compared with the five-item FFP. We compared the phenotypes via receiver operator characteristic curves, agreement in classifying frailty, and criterion validity via association with having experienced falls. Mod-FP classified 8% of PWH as frail, whereas FFP classified 9%. The area under the receiver operator characteristic curve for Mod-FP classifying frailty was 0.93 (95% CI = 0.91–0.96). We observed kappa ranging from 0.64 (unweighted) to 0.75 (weighted) for categorizing frailty status. Both definitions found frailty associated with a greater odds of experiencing a fall; FFP estimated a slightly greater magnitude (i.e., OR) for the association than Mod-FP. The Mod-FP has good performance in measuring frailty among PWH and is reasonable to use when the gold standards of observed assessments (i.e., weakness and slowness) are not feasible.