bioRxiv · Oct 31, 2017
The frailty index is associated with the need for care in an aging Swedish population
By Jylhävä J, Jiang M, Foebel AD et al.
Abstract Background The Rockwood frailty index (FI) has proven a valid predictor of mortality, institutionalization and requirement for health services. However, little is known about the relationship between the FI and the need for care – an indication of dependency. To this end, we ascertained the associations between the FI and the need for current and future care. Methods A Rockwood-based FI was tested for association with the current need for care and care needs in the future during a 23-year follow-up in the Swedish Adoption/Twin Study of Aging (n=1477; 623 men, 854 women; aged 29-95 years at baseline). Need for care was defined as receiving help at least once a week in daily routines. Age, sex, education, living alone, smoking status and body mass index were considered as covariates. Results The FI was independently associated with current need for care (OR=1.27 for accumulation of one deficit, 95%CI 1.20–1.34) and future need for care (HR=1.12 for accumulation of one deficit, 95%CI 1.08–1.15). Co-twin control analyses confirmed the results; the pair member currently needing care had higher median FI levels compared to their co-twin not needing care, and the pair member having higher baseline FI had shorter median time to the onset of future care need compared to their co-twin with lower FI. Conclusions The FI is a determinant of current care needs and predictive of care needs in the future. The FI may thus represent a risk indicator for dependency and offer an amenable target for preventive measures.