• Imaina S Widagdo, Nicole Pratt, Mary Russell, and Elizabeth E Roughead.
• Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
• Age Ageing. 2015 Nov 1; 44 (6): 967-72.

BackgroundThere are several different frailty measures available for identifying the frail elderly. However, their predictive performance in an Australian population has not been examined.ObjectiveTo examine the predictive performance of four internationally validated frailty measures in an older Australian population.MethodsA retrospective study in the Australian Longitudinal Study of Ageing (ALSA) with 2,087 participants. Frailty was measured at baseline using frailty phenotype (FP), simplified frailty phenotype (SFP), frailty index (FI) and prognostic frailty score (PFS). Odds ratios (OR) were calculated to measure the association between frailty and outcomes at Wave 3 including mortality, hospitalisation, nursing home admission, fall and a combination of all outcomes. Predictive performance was measured by assessing sensitivity, specificity, positive and negative predictive values (PPV and NPV) and likelihood ratio (LR). Area under the curve (AUC) of dichotomised and the multilevel or continuous model of the measures was examined.ResultsPrevalence of frailty varied from 2% up to 49% between the measures. Frailty was significantly associated with an increased risk of any outcome, OR (95% confidence interval) for FP: 1.9 (1.4-2.8), SFP: 3.6 (1.5-8.8), FI: 3.4 (2.7-4.3) and PFS: 2.3 (1.8-2.8). PFS had high sensitivity across all outcomes (sensitivity: 55.2-77.1%). The PPV for any outcome was highest for SFP and FI (70.8 and 69.7%, respectively). Only FI had acceptable accuracy in predicting outcomes, AUC: 0.59-0.70.ConclusionsBeing identified as frail by any of the four measures was associated with an increased risk of outcomes; however, their predictive accuracy varied.© The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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