Development and validation of a frailty index in the Longitudinal Aging Study Amsterdam

Emiel O Hoogendijk, Olga Theou, Kenneth Rockwood, Bregje D Onwuteaka-Philipsen, Dorly J H Deeg, Martijn Huisman

Research output: Contribution to JournalArticleAcademicpeer-review


BACKGROUND: Frailty is a state of increased vulnerability to adverse outcomes. The frailty index (FI), defined by the deficit accumulation approach, is a sensitive instrument to measure levels of frailty, and therefore important for longitudinal studies of aging.

AIMS: To develop an FI in the Longitudinal Aging Study Amsterdam (LASA), and to examine the predictive validity of this FI for 19-year mortality.

METHODS: LASA is an ongoing study among Dutch older adults, based on a nationally representative sample. A 32-item FI (LASA-FI) was developed at the second LASA measurement wave (1995-1996) among 2218 people aged 57-88 years. An FI score between 0 and 1 was calculated for each individual. The LASA-FI included health deficits from the physical, mental and cognitive domain and can be constructed for most LASA measurement waves. Associations with 19-year mortality were assessed using Kaplan-Meier curves and Cox proportional hazards models.

RESULTS: The mean LASA-FI score was 0.19 (SD = 0.12), with a 99% upper limit of 0.53. Scores were higher in women than men (women = 0.20, SD = 0.13 vs. men = 0.17, SD = 0.11, p < 0.001). The average age-related increase in the log-transformed LASA-FI score was 3.5% per year. In a model adjusted for age and sex, the FI score was significantly associated with 19-year all-cause mortality (HR per 0.01 = 1.03, 95% CI 1.03-1.04, p < 0.001).

DISCUSSION/CONCLUSIONS: The key characteristics of the LASA-FI were in line with findings from previous FI studies in population-based samples of older people. The LASA-FI score was associated with mortality and may serve as an internal and external reference value.

Original languageEnglish
Pages (from-to)927-933
Number of pages7
JournalAging - Clinical and Experimental Research
Issue number5
Publication statusPublished - Oct 2017


  • Journal Article


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