Development and Validation of a Frailty Index for Ischemic Stroke Patients

Xueying Zhu; Fang Fang; Yu Qiu; Yaxin Nie; Ning Yan; Yaoyue Hu

doi:10.62051/ijphmr.v3n3.09

Authors

Xueying Zhu
Fang Fang
Yu Qiu
Yaxin Nie
Ning Yan
Yaoyue Hu

DOI:

https://doi.org/10.62051/ijphmr.v3n3.09

Keywords:

Frailty, Frailty Index, Ischemic stroke, Reliability and validity test

Abstract

This study aimed to develop and validate a frailty index (FI) tailored to ischemic stroke patients based on the cumulative deficit model. Using data from 537 patients, 34 health-related variables were initially selected through literature review. A series of statistical methods, including correlation analysis, critical ratio method, homogeneity testing, and factor analysis, were applied to screen variables. 31 variables covering physical, psychological, and cognitive domains were retained. The final FI showed good internal consistency (Cronbach’s α = 0.879), construct validity, and moderate criterion validity with the Fried’s frailty phenotype (FP) (r = 0.504, P < 0.001). These findings support the FI as a reliable and valid tool for assessing frailty in ischemic stroke patients, offering a multidimensional and sensitive measure suitable for clinical practice and long-term monitoring.

References

[1] KOJIMA G, ILIFFE S, WALTERS K. Frailty index as a predictor of mortality: a systematic review and meta-analysis [J]. Age Ageing, 2018, 47(2): 193-200.

[2] HOOGENDIJK E O, AFILALO J, ENSRUD K E, et al. Frailty: implications for clinical practice and public health [J]. Lancet, 2019, 394(10206): 1365-75.

[3] KOJIMA G. Frailty as a Predictor of Future Falls Among Community-Dwelling Older People: A Systematic Review and Meta-Analysis [J]. J Am Med Dir Assoc, 2015, 16(12): 1027-33.

[4] KOJIMA G. Frailty as a predictor of disabilities among community-dwelling older people: a systematic review and meta-analysis [J]. Disabil Rehabil, 2017, 39(19): 1897-908.

[5] VOS T, LIM S S, ABBAFATI C, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019 [J]. The lancet, 2020, 396(10258): 1204-22.

[6] BURTON J K, STEWART J, BLAIR M, et al. Prevalence and implications of frailty in acute stroke: systematic review & meta-analysis [J]. Age and Ageing, 2022, 51(3): afac064.

[7] SUTTON J L, GOULD R L, DALEY S, et al. Psychometric properties of multicomponent tools designed to assess frailty in older adults: a systematic review [J]. BMC geriatrics, 2016, 16: 1-20.

[8] BLODGETT J, THEOU O, KIRKLAND S, et al. Frailty in NHANES: Comparing the frailty index and phenotype [J]. Arch Gerontol Geriatr, 2015, 60(3): 464-70.

[9] FRIED L P, TANGEN C M, WALSTON J, et al. Frailty in older adults: evidence for a phenotype [J]. J Gerontol A Biol Sci Med Sci, 2001, 56(3): M146-56.

[10] MITNITSKI A B, MOGILNER A J, ROCKWOOD K. Accumulation of deficits as a proxy measure of aging [J]. ScientificWorldJournal, 2001, 1: 323-36.

[11] YU Q. The establishment of a radiation-induced xerostomia evaluation system for nasopharyngeal carcinoma based on patient-reported outcome [D], 2022.

[12] SEARLE S D, MITNITSKI A, GAHBAUER E A, et al. A standard procedure for creating a frailty index [J]. BMC geriatrics, 2008, 8: 1-10.

[13] THEOU O, HAVIVA C, WALLACE L, et al. How to construct a frailty index from an existing dataset in 10 steps [J]. Age and ageing, 2023, 52(12): afad221.

[14] KLEINENBERG-TALSMA N, VAN DER LUCHT F, JAGER-WITTENAAR H, et al. Development of a frailty index from the Dutch public health monitor 2016 and investigation of its psychometric properties: a cross-sectional study [J]. Archives of Public Health, 2023, 81(1): 78.

[15] GU F. Compilation and preliminary application of Symptom Cluster Scale for Inflammatory Bowel Disease based on the Symptoms Experience Model [D], 2020.

[16] FEI W, JINGQI T, XIAONAN S, et al. Design and Development of Scales in Primary Care:Practical Steps and Statistical Methods [J]. Chinese General Practice, 2024, 27(13): 1573-83.

[17] LEI C. Development of a Modular Postoperative Rehabilitation Assessment System for Lung Cancer Based on PRO [D], 2024.

[18] QI M. Development of self-management ability questionnaire for gestational diabetes mellitus patients and its reliability and validity test [D], 2018.