How to construct a frailty index from an existing dataset in 10 steps

TitleHow to construct a frailty index from an existing dataset in 10 steps
Publication TypeJournal Article
Year of Publication2023
AuthorsTheou, O, Haviva, C, Wallace, L, Searle, SD, Rockwood, K
JournalAge and Ageing
Volume52
Keywordsfrail, Frailty, Health and Retirement Study, health measurement, Morbidity, Older people
Abstract

Background: The frailty index is commonly used in research and clinical practice to quantify health. Using a health deficit accumulation model, a frailty index can be calculated retrospectively from data collected via survey, interview, performance test, laboratory report, clinical or administrative medical record, or any combination of these. Here, we offer a detailed 10-step approach to frailty index creation, with a worked example. Methods: We identified 10 steps to guide the creation of a valid and reliable frailty index. We then used data from waves 5 to 12 of the Health and Retirement Study (HRS) to illustrate the steps. Results: The 10 steps are as follows: (1) select every variable that measures a health problem; (2) exclude variables with more than 5% missing values; (3) recode the responses to 0 (no deficit) through 1 (deficit); (4) exclude variables when coded deficits are too rare (< 1%) or too common (> 80%); (5) screen the variables for association with age; (6) screen the variables for correlation with each other; (7) count the variables retained; (8) calculate the frailty index scores; (9) test the characteristics of the frailty index; (10) use the frailty index in analyses. In our worked example, we created a 61-item frailty index following these 10 steps. Conclusions: This 10-step procedure can be used as a template to create one continuous health variable. The resulting high-information variable is suitable for use as an exposure, predictor or control variable, or an outcome measure of overall health and ageing. © 2023 The Author(s). Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.

DOI10.1093/ageing/afad221
Citation KeyTheou2023