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Research

Measuring daily functioning in older persons using a frailty index: a cohort study based on routine primary care data

Willeke M Ravensbergen, Jeanet W Blom, Andrea WM Evers, Mattijs E Numans, Margot WM de Waal and Jacobijn Gussekloo
British Journal of General Practice 2020; 70 (701): e866-e873. DOI: https://doi.org/10.3399/bjgp20X713453
Willeke M Ravensbergen
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden.
Roles: PhD candidate
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Jeanet W Blom
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden.
Roles: Senior researcher
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Andrea WM Evers
Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, the Netherlands.
Roles: Professor of health psychology
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Mattijs E Numans
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden.
Roles: Professor of general practice
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Margot WM de Waal
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden.
Roles: Senior researcher
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Jacobijn Gussekloo
Department of Internal medicine, Section Gerontology and Geriatrics, Leiden University Medical Center, Leiden.
Roles: Professor of research in primary care
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Abstract

Background Electronic health records (EHRs) are increasingly used for research; however, multicomponent outcome measures such as daily functioning cannot yet be readily extracted.

Aim To evaluate whether an electronic frailty index based on routine primary care data can be used as a measure for daily functioning in research with community-dwelling older persons (aged ≥75 years).

Design and setting Cohort study among participants of the Integrated Systemic Care for Older People (ISCOPE) trial (11 476 eligible; 7285 in observational cohort; 3141 in trial; over-representation of frail people).

Method At baseline (T0) and after 12 months (T12), daily functioning was measured with the Groningen Activities Restriction Scale (GARS, range 18–72). Electronic frailty index scores (range 0–1) at T0 and T12 were computed from the EHRs. The electronic frailty index (electronic Frailty Index — Utrecht) was tested for responsiveness and compared with the GARS as a gold standard for daily functioning.

Results In total, 1390 participants with complete EHR and follow-up data were selected (31.4% male; median age = 81 years, interquartile range = 78–85). The electronic frailty index increased with age, was higher for females, and lower for participants living with a partner. It was responsive after an acute major medical event; however, the correlation between the electronic frailty index and GARS at T0 and over time was limited.

Conclusion Because the electronic frailty index does not reflect daily functioning, further research on new methods to measure daily functioning with routine care data (for example, other proxies) is needed before EHRs can be a useful data source for research with older persons.

  • activities of daily living
  • aged
  • electronic health records
  • frail older persons
  • general practice
  • Received February 25, 2020.
  • Revision requested April 13, 2020.
  • Accepted May 19, 2020.
  • © British Journal of General Practice 2020
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British Journal of General Practice: 70 (701)
British Journal of General Practice
Vol. 70, Issue 701
December 2020
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Measuring daily functioning in older persons using a frailty index: a cohort study based on routine primary care data
Willeke M Ravensbergen, Jeanet W Blom, Andrea WM Evers, Mattijs E Numans, Margot WM de Waal, Jacobijn Gussekloo
British Journal of General Practice 2020; 70 (701): e866-e873. DOI: 10.3399/bjgp20X713453

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Measuring daily functioning in older persons using a frailty index: a cohort study based on routine primary care data
Willeke M Ravensbergen, Jeanet W Blom, Andrea WM Evers, Mattijs E Numans, Margot WM de Waal, Jacobijn Gussekloo
British Journal of General Practice 2020; 70 (701): e866-e873. DOI: 10.3399/bjgp20X713453
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Keywords

  • activities of daily living
  • aged
  • electronic health records
  • frail older persons
  • general practice

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Print ISSN: 0960-1643
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