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A frailty index for UK Biobank participants

By Dylan M. Williams, Juulia Jylhävä, Nancy Pedersen, Sara Hagg

Posted 13 Dec 2017
bioRxiv DOI: 10.1101/233692 (published DOI: 10.1093/gerona/gly094)

Background Frailty indices (FIs) measure variation in health between aging individuals. Researching FIs in resources with large-scale genetic and phenotypic data will provide insights into the causes and consequences of frailty. Thus, we aimed to develop an FI using UK Biobank data, a cohort study of 500,000 middle-aged and older adults. Methods An FI was calculated using 49 self-reported questionnaire items on traits covering health, presence of diseases and disabilities, and mental wellbeing, according to standard protocol. We used multiple imputation to derive FI values for the entire eligible sample in the presence of missing item data (N =500,336). To validate the measure, we assessed associations of the FI with age, sex, and risk of all-cause mortality (follow-up ≤ 9.7 years) using linear and Cox proportional hazards regression models. Results Mean FI in the cohort was 0.125 (standard deviation = 0.075), and there was a curvilinear trend towards higher values in older participants. FI values were also marginally higher on average in women than men. In survival models, 10% higher baseline frailty (i.e. a 0.1 FI increment) was associated with higher risk of death (hazard ratio (HR) = 1.65; 95% confidence interval: 1.62, 1.68). Associations were stronger in younger participants than in old, and in men compared to women (HRs: 1.72 vs. 1.56, respectively). Conclusions The FI is a valid measure of frailty in UK Biobank. The cohort data are open-access for researchers to use, and we provide script for deriving this tool to facilitate future studies on frailty.

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