Frailty or Frailties: Exploring Frailty Index Subdimensions in the English Longitudinal Study of Ageing

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Main Authors: Johnson, Lara, Guthrie, Bruce, Kelly, Paul A T, Anand, Atul, Marshall, Alan, Seth, Sohan
Format: Preprint
Published: 2024
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author Johnson, Lara
Guthrie, Bruce
Kelly, Paul A T
Anand, Atul
Marshall, Alan
Seth, Sohan
author_facet Johnson, Lara
Guthrie, Bruce
Kelly, Paul A T
Anand, Atul
Marshall, Alan
Seth, Sohan
contents Background: Frailty, a state of increased vulnerability to adverse health outcomes, has garnered significant attention in research and clinical practice. Existing constructs aggregate clinical features or health deficits into a single score. While simple and interpretable, this approach may overlook the complexity of frailty and not capture the full range of variation between individuals. Methods: Exploratory factor analysis was used to infer latent dimensions of a frailty index constructed using survey data from the English Longitudinal Study of Ageing (ELSA), wave 9. The dataset included 58 self-reported health deficits in a representative sample of community-dwelling adults aged 65+ (N = 4971). Deficits encompassed chronic disease, general health status, mobility, independence with activities of daily living, psychological wellbeing, memory and cognition. Multiple linear regression examined associations with CASP-19 quality of life scores. Results: Factor analysis revealed four frailty subdimensions. Based on the component deficits with the highest loading values, these factors were labelled "Mobility Impairment and Physical Morbidity", "Difficulties in Daily Activities", "Mental Health" and "Disorientation in Time". The four subdimensions were a better predictor of quality of life than frailty index scores. Conclusions: Distinct subdimensions of frailty can be identified from standard index scores. A decomposed approach to understanding frailty has potential to provide a more nuanced understanding of an individual's state of health across multiple deficits.
format Preprint
id arxiv_https___arxiv_org_abs_2403_00472
institution arXiv
publishDate 2024
record_format arxiv
spellingShingle Frailty or Frailties: Exploring Frailty Index Subdimensions in the English Longitudinal Study of Ageing
Johnson, Lara
Guthrie, Bruce
Kelly, Paul A T
Anand, Atul
Marshall, Alan
Seth, Sohan
Applications
Background: Frailty, a state of increased vulnerability to adverse health outcomes, has garnered significant attention in research and clinical practice. Existing constructs aggregate clinical features or health deficits into a single score. While simple and interpretable, this approach may overlook the complexity of frailty and not capture the full range of variation between individuals. Methods: Exploratory factor analysis was used to infer latent dimensions of a frailty index constructed using survey data from the English Longitudinal Study of Ageing (ELSA), wave 9. The dataset included 58 self-reported health deficits in a representative sample of community-dwelling adults aged 65+ (N = 4971). Deficits encompassed chronic disease, general health status, mobility, independence with activities of daily living, psychological wellbeing, memory and cognition. Multiple linear regression examined associations with CASP-19 quality of life scores. Results: Factor analysis revealed four frailty subdimensions. Based on the component deficits with the highest loading values, these factors were labelled "Mobility Impairment and Physical Morbidity", "Difficulties in Daily Activities", "Mental Health" and "Disorientation in Time". The four subdimensions were a better predictor of quality of life than frailty index scores. Conclusions: Distinct subdimensions of frailty can be identified from standard index scores. A decomposed approach to understanding frailty has potential to provide a more nuanced understanding of an individual's state of health across multiple deficits.
title Frailty or Frailties: Exploring Frailty Index Subdimensions in the English Longitudinal Study of Ageing
topic Applications
url https://arxiv.org/abs/2403.00472