Which comorbidity index is more appropriate for geriatric patients from the frailty perspective?

• Published in: European geriatric medicine Vol. 15; no. 1; pp. 115 - 125
• Main Authors: Hafızoğlu, Merve, Odacı Cömertoğlu, Ezgi, Öztürk, Yelda, Kahyaoğlu, Zeynep, Çavuşoglu, Çağatay, Balcı, Cafer, Halil, Meltem Gülhan, Erden Aki, Özlem, Cankurtaran, Mustafa, Doğu, Burcu Balam
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-02-2024
• Subjects: Geriatrics/Gerontology; Internal Medicine; Medicine; Medicine & Public Health; Research Paper; Frailty; Psychological frailty; Older adults; Comorbidity indices; Social frailty; Physical frailty
• ISSN: 1878-7649; 1878-7657; 1878-7657
• DOI: 10.1007/s41999-023-00851-5

Key summary points
Aim
To evaluate the relationship between comorbidity indices and frailty scales in community-dwelling older adults.
Findings
The CIRS-G index was found to be superior to other indices in predicting the presence of frailty among comorbidity indices, and only GIC scores showed significant results in predicting mortality.
Message
Although CIRS-G seems to be the index most associated with physical, psychological and social frailty, no single comorbidity index should be recommended for predicting clinical outcomes in older adults.
Objectives
This study examined the relationship between comorbidity indices and physical, psychologic and social frailty and 1-year mortality.
Methods
A cross-sectional analysis was conducted with 136 community-dwelling older adults. The relationship of 4 comorbidity indices (CIRS-G, ACCI, GIC, ICED) with 3 different frailty scales (FRAIL, CFS, TFI) was examined.
Results
The participants’ median age was 72 years (65–90); 62% of the participants were female. Overall, 15.4% of the participants were living with frailty according to the FRAIL scale, 27.9% of them according to the CFS, 58.8% of them according to the TFI, 47.7% of them living with psychological frailty, and 28.6% of them living with social frailty. There were significant and moderate correlations between CIRS-G and FRAIL, CFS and TFI total scores, TFI-Psychological scores and TFI-Social scores (respectively; p < 0.001, r = 0.530; p < 0.001, r = 0.471; p < 0.001, r = 0.535; p < 0.001, r = 0.402; p = 0.016 r = 0.206). AUC for CIRS-G was calculated as 0.716 among comorbidity indices in predicting the presence of frailty according to the FRAIL scale (p = 0.002, 95%CI [0.60–0.82]), 0.765 according to the CFS (p < 0.001, 95%CI [0.66–0.86]), 0.746 according to the TFI (p < 0.001, 95%CI [0.66–0.82]).
Conclusion
The CIRS-G index was found to be superior to other indices in predicting the presence of frailty of comorbidity indices, and only GIC scores showed significant results in predicting mortality. However, it would not be the right approach to recommend a single comorbidity index when evaluating older adults.