Development and validation of a shortened and practical frailty index for people with intellectual disabilities.
A 17-item caregiver-friendly frailty index validly predicts mortality risk in adults with intellectual disabilities.
01Research in Context
What this study did
The team trimmed a 51-item frailty index down to 17 yes-or-no questions.
Caregivers can finish the short form in about five minutes.
They checked the new tool against the old one in 982 adults with intellectual disabilities aged 50 and up.
What they found
The 17-item score lined up almost perfectly with the full index.
It also forecast who would die during the follow-up window.
A higher score meant a higher mortality risk, so the short form works as a warning signal.
How this fits with other research
Berkovits et al. (2014) showed the original index predicts daily-living decline in 703 older adults with ID. The 2022 paper keeps that power while cutting the items by two-thirds.
de Korte et al. (2021) shortened a cognitive test for the same group. Both studies prove you can keep validity and save time.
Tabin et al. (2021) warn that even good tools flop if staff skip steps. The new frailty index is brief, but you will still need to train caregivers so they use it right.
Why it matters
You now have a 17-item checklist that spots frailty and death risk without a long clinic visit. Use it during annual planning to flag clients who need exercise, nutrition, or medical follow-up before problems snowball.
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02At a glance
03Original abstract
BACKGROUND: There is no widely used instrument to detect frailty in people with intellectual disabilities (IDs). We aimed to develop and validate a shorter and more practical version of a published frailty index for people with IDs. METHOD: This study was part of the longitudinal 'Healthy Ageing and Intellectual Disability' study. We included 982 people with IDs aged 50 years and over. The previously developed and validated ID-Frailty Index consisting of 51 deficits was used as the basis for the shortened version, the ID-FI Short Form. Content of the ID-FI Short Form was based on statistics and clinical and practical feasibility. We evaluated the precision and validity of the ID-FI Short Form using the internal consistency, the correlation between the ID-FI Short Form and the original ID-Frailty Index, the agreement in dividing participants in the categories non-frail, pre-frail and frail, and the association with survival. RESULTS: Seventeen deficits from the original ID-Frailty Index were selected for inclusion in the ID-FI Short Form. All deficits of the ID-FI Short Form are clinically and practically feasible to assess for caregivers and therapists supporting people with ID. We showed acceptable internal consistency with Cronbach's alpha of 0.75. The Pearson correlation between the ID-Frailty Index and the ID-FI Short Form was excellent (r = 0.94, P < 0.001). We observed a good agreement between the full and short forms in dividing the participants in the frailty categories, with a kappa statistic of 0.63. The ID-FI Short Form was associated with survival; with every 1/100 increase on the ID-FI Short Form, the mortality probability increased by 7% (hazard ratio 1.07, P < 0.001). CONCLUSION: The first validation of the ID-FI Short Form shows it to be a promising, practical tool to assess the frailty status of people with ID.
Journal of intellectual disability research : JIDR, 2022 · doi:10.1111/jir.12907