|RP#1: The International Database Inquiry on Frailty (FrData)
PRINCIPAL INVESTIGATORS: H Bergman, C Wolfson;
CO-INVESTIGATOR: F Béland;
COLLABORATORS: K Bandeen-Roche, J Brodsky, D Deeg, L Ferrucci, L Fried, J Guralnik, L Gutiérrez-Robledo, D Kuh, S Maggi, A Otero, F Paccaud, M Puts, H Payette, B Santos-Eggimann;
RESEARCH STAFF: N Sourial (Study Coordinator), J Fletcher, B Zhu, S Karunananthan
POST-DOCTORAL FELLOWS: J Quail; D Weiss
OBJECTIVES: Frailty has emerged as an increasingly important concept; however, debate still remains over its characteristics1. The objectives of this study are: 1) to examine the association among 7 candidate frailty domains; and 2) to test the ability of the domains, individually and in combination, to predict adverse outcomes.
METHODS: Seven frailty domains were selected based on a literature review by the Canadian Initiative on Frailty and Aging: nutrition, physical activity, mobility, strength, energy, cognition, and mood. To explore the association among these domains, Multiple Correspondence Analysis (MCA)2, a multivariate graphical technique, was selected. The predictive validity of these domains will be evaluated using appropriate regression models.
Data from 14 existing longitudinal studies of ageing from 8 different countries will be used to ascertain the consistency of the findings: 3 pilot studies – the Montreal Unmet Needs Study (MUNS)3 [C Wolfson], the Canadian Study of Health and Aging4 [C Wolfson] and the System of Integrated Services for Older Persons (French acronym, SIPA)5 [F Beland] and 11 international studies – NuAGE6 [H Payette], the Baltimore Longitudinal Study of Aging7 [L Ferrucci], InCHIANTI8 [L Ferrucci], the Cardiovascular Health Study9 [L Fried], Established Populations for Epidemiologic Studies of the Elderly (EPESE)10 [J Guralnik], the Mexican Health and Aging Study (MHAS) [L Gutiérrez-Robledo], the Longitudinal Aging Study Amsterdam (LASA)11 [D Deeg], the Italian Longitudinal Study of Aging12 [S Maggi], the Lausanne cohort LC 65+ [B Santos-Eggimann], Aging in Leganes13 [A Otero] and the Study on Frailty in Israel [J Brodsky]. The budget will allow us to apply the methods developed in the pilot to 5 of the international databases: NuAge, LASA, EPESE, MHAS and InChianti. Additional sources of funding will be sought in order to apply the methods to the remaining studies.
EXPECTED RESULTS: The results of this study will serve to elucidate the associations among potential frailty domains for which no published research exists. Pilot results suggest that these domains may be measuring a common underlying construct, capable of distinguishing frail from non-frail individuals. Replication of the methodology in several databases will allow us to exploit a large and diverse pool of samples of community-dwelling elderly persons in order to evaluate the robustness of the findings.
TIMELINE: This study will be conducted over a 4-year period. Pilot work for Objective 1 was conducted between January 2005 and March 2006. Selection of measures in the 5 selected international databases is underway and statistical analyses are expected to be completed by February 2009. Methodology for Objective 2 should be finalized by November 2007. Pilot work for Objective 2 will be completed by April 2008. Replication in the international studies combined with a meeting with the international collaborators to discuss the implications of the findings is predicted for April 2011. A final report of the findings will be submitted for publication in September 2011.
INSTITUTIONAL SETTING: Development of the methodology, coordination of the project and statistical analysis will be conducted by the Solidage FrData team, which is housed in the Lady Davis Institute (LDI) for Medical Research at the Jewish General Hospital. Data preparation for the international databases will be conducted by the collaborators in their respective institutions.
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