Developing and evaluating a frailty index for older South Africans—findings from the HAALSI study
| dc.contributor.author | Fred J. Barker | |
| dc.contributor.author | Justine I. Davies | |
| dc.contributor.author | F. Xavier Gomez-Olive | |
| dc.contributor.author | Kathleen Kahn | |
| dc.contributor.author | Fiona E. Matthews | |
| dc.contributor.author | Collin F. Payne | |
| dc.contributor.author | Joshua A. Salomon | |
| dc.contributor.author | Stephen M. Tollman | |
| dc.contributor.author | Alisha N.Wade | |
| dc.contributor.author | Richard W.Walker | |
| dc.contributor.author | Miles D.Witham | |
| dc.date.accessioned | 2024-07-25T10:00:31Z | |
| dc.date.available | 2024-07-25T10:00:31Z | |
| dc.date.issued | 2021-06-09 | |
| dc.description.abstract | Background: despite rapid population ageing, few studies have investigated frailty in older people in sub-Saharan Africa. We tested a cumulative deficit frailty index in a population of older people from rural South Africa. Methods: analysis of cross-sectional data from the Health and Ageing in Africa: Longitudinal Studies of an INDEPTH Community (HAALSI) study. We used self-reported diagnoses, symptoms, activities of daily living, objective physiological indices and blood tests to calculate a 32-variable cumulative deficit frailty index. We fitted Cox proportional hazards models to test associations between frailty category and all-cause mortality. We tested the discriminant ability of the frailty index to predict one-year mortality alone and in addition to age and sex. Results: in total 3,989 participants were included in the analysis, mean age 61 years (standard deviation 13); 2,175 (54.5%) were women. The median frailty index was 0.13 (interquartile range 0.09–0.19); Using population-specific cutoffs, 557 (14.0%) had moderate frailty and 263 (6.6%) had severe frailty. All-cause mortality risk was related to frailty severity independent of age and sex (hazard ratio per 0.01 increase in frailty index: 1.06 [95% confidence interval 1.04–1.07]). The frailty index alone showed moderate discrimination for one-year mortality: c-statistic 0.68–0.76; combining the frailty index with age and sex improved performance (c-statistic 0.77–0.81). Conclusion: frailty measured by cumulative deficits is common and predicts mortality in a rural population of older South Africans. The number of measures needed may limit utility in resource-poor settings. | |
| dc.description.submitter | PM2024 | |
| dc.faculty | Faculty of Health Sciences | |
| dc.identifier.uri | https://hdl.handle.net/10539/39858 | |
| dc.language.iso | en | |
| dc.school | School of Public Health | |
| dc.subject | frailty index, older people, global health | |
| dc.title | Developing and evaluating a frailty index for older South Africans—findings from the HAALSI study | |
| dc.type | Article |