Development and Validation of a Clinical Frailty Index for the World Trade Center General Responder Cohort

Overview

Journal J Aging Health

Publisher Sage Publications

Specialty Geriatrics

Date 2021 Mar 12

PMID 33706594

Citations 1

Authors

Ghalib A Bello

Katherine A Ornstein

Roberto G Lucchini

William W Hung

Fred C Ko

Elena Colicino

Emanuela Taioli

Michael A Crane

Andrew C Todd

Affiliations

Soon will be listed here.

Abstract

To develop and validate a clinical frailty index to characterize aging among responders to the 9/11 World Trade Center (WTC) attacks. This study was conducted on health monitoring data on a sample of 6197 responders. A clinical frailty index, WTC FI-Clinical, was developed according to the cumulative deficit model of frailty. The validity of the resulting index was assessed using all-cause mortality as an endpoint. Its association with various cohort characteristics was evaluated. The sample's median age was 51 years. Thirty items were selected for inclusion in the index. It showed a strong correlation with age, as well as significant adjusted associations with mortality, 9/11 exposure severity, sex, race, pre-9/11 occupation, education, and smoking status. The WTC FI-Clinical highlights effects of certain risk factors on aging within the 9/11 responder cohort. It will serve as a useful instrument for monitoring and tracking frailty within this cohort.

Citing Articles

Health effects following exposure to dust from the World Trade Center disaster: An update.

Mears M, Aslaner D, Barson C, Cohen M, Gorr M, Wold L Life Sci. 2021; 289:120147.

PMID: 34785191 PMC: 8791014. DOI: 10.1016/j.lfs.2021.120147.

References

Clouston S, Diminich E, Kotov R, Pietrzak R, Richards M, Spiro 3rd A . Incidence of mild cognitive impairment in World Trade Center responders: Long-term consequences of re-experiencing the events on 9/11/2001. Alzheimers Dement (Amst). 2019; 11:628-636. PMC: 6733774. DOI: 10.1016/j.dadm.2019.07.006. View

Shapiro M, Wallenstein S, Dasaro C, Lucchini R, Sacks H, Teitelbaum S . Cancer in General Responders Participating in World Trade Center Health Programs, 2003-2013. JNCI Cancer Spectr. 2020; 4(1):pkz090. PMC: 7050150. DOI: 10.1093/jncics/pkz090. View

Kojima G, Iliffe S, Walters K . Frailty index as a predictor of mortality: a systematic review and meta-analysis. Age Ageing. 2017; 47(2):193-200. DOI: 10.1093/ageing/afx162. View

Mitnitski A, Graham J, Mogilner A, Rockwood K . Frailty, fitness and late-life mortality in relation to chronological and biological age. BMC Geriatr. 2002; 2:1. PMC: 88955. DOI: 10.1186/1471-2318-2-1. View

Mitnitski A, Collerton J, Martin-Ruiz C, Jagger C, von Zglinicki T, Rockwood K . Age-related frailty and its association with biological markers of ageing. BMC Med. 2015; 13:161. PMC: 4499935. DOI: 10.1186/s12916-015-0400-x. View

Zaslavsky O, Cochrane B, Thompson H, Woods N, Herting J, Lacroix A . Frailty: a review of the first decade of research. Biol Res Nurs. 2012; 15(4):422-32. DOI: 10.1177/1099800412462866. View

Mitnitski A, Mogilner A, Rockwood K . Accumulation of deficits as a proxy measure of aging. ScientificWorldJournal. 2003; 1:323-36. PMC: 6084020. DOI: 10.1100/tsw.2001.58. View

House R, Sauve J, Jiang D . Noise-induced hearing loss in construction workers being assessed for hand-arm vibration syndrome. Can J Public Health. 2010; 101(3):226-9. PMC: 6974259. View

Bello G, Teitelbaum S, Lucchini R, Dasaro C, Shapiro M, Kaplan J . Assessment of cumulative health risk in the World Trade Center general responder cohort. Am J Ind Med. 2017; 61(1):63-76. DOI: 10.1002/ajim.22786. View

10.

Tarazona-Santabalbina F, Gomez-Cabrera M, Perez-Ros P, Martinez-Arnau F, Cabo H, Tsaparas K . A Multicomponent Exercise Intervention that Reverses Frailty and Improves Cognition, Emotion, and Social Networking in the Community-Dwelling Frail Elderly: A Randomized Clinical Trial. J Am Med Dir Assoc. 2016; 17(5):426-33. DOI: 10.1016/j.jamda.2016.01.019. View

11.

Woo J, Goggins W, Sham A, Ho S . Public health significance of the frailty index. Disabil Rehabil. 2006; 28(8):515-21. DOI: 10.1080/09638280500215867. View

12.

Macdonald S, Travers J, Ni She E, Bailey J, Romero-Ortuno R, Keyes M . Primary care interventions to address physical frailty among community-dwelling adults aged 60 years or older: A meta-analysis. PLoS One. 2020; 15(2):e0228821. PMC: 7006935. DOI: 10.1371/journal.pone.0228821. View

13.

Dent E, Hoogendijk E, Moldovan M . Frailty index from routine laboratory measurements correlates with leukocyte telomere length. Geriatr Gerontol Int. 2018; 18(4):654-655. DOI: 10.1111/ggi.13257. View

14.

Won C, Lee Y, Lee S, Kim M . Development of Korean Frailty Index for Primary Care (KFI-PC) and Its Criterion Validity. Ann Geriatr Med Res. 2020; 24(2):125-138. PMC: 7370789. DOI: 10.4235/agmr.20.0021. View

15.

Blodgett J, Theou O, Howlett S, Wu F, Rockwood K . A frailty index based on laboratory deficits in community-dwelling men predicted their risk of adverse health outcomes. Age Ageing. 2016; 45(4):463-8. DOI: 10.1093/ageing/afw054. View

16.

Prince C, Noren Hooten N, Mode N, Zhang Y, Ejiogu N, Becker K . Frailty in middle age is associated with frailty status and race-specific changes to the transcriptome. Aging (Albany NY). 2019; 11(15):5518-5534. PMC: 6710041. DOI: 10.18632/aging.102135. View

17.

Clegg A, Young J, Iliffe S, Rikkert M, Rockwood K . Frailty in elderly people. Lancet. 2013; 381(9868):752-62. PMC: 4098658. DOI: 10.1016/S0140-6736(12)62167-9. View

18.

Howlett S, Rockwood M, Mitnitski A, Rockwood K . Standard laboratory tests to identify older adults at increased risk of death. BMC Med. 2014; 12:171. PMC: 4190374. DOI: 10.1186/s12916-014-0171-9. View

19.

Rockwood K, Mitnitski A . How Might Deficit Accumulation Give Rise to Frailty?. J Frailty Aging. 2016; 1(1):8-12. DOI: 10.14283/jfa.2012.2. View

20.

Theou O, Sluggett J, Bell J, Lalic S, Cooper T, Robson L . Frailty, Hospitalization, and Mortality in Residential Aged Care. J Gerontol A Biol Sci Med Sci. 2018; 73(8):1090-1096. DOI: 10.1093/gerona/glx185. View