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Santamaria Navarro, CristinaSupervisor

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Modelización matemática de la fragilidad valorada mediante el Índice Frágil-VIG y el SPPB, de la dependencia para las actividades básicas de la vida diaria y de la mortalidad en población general de 70 años o más. Validación del Índice Frágil-VIG respecto al SPPB.

Date read: 2024-07-01 {_iPublic_txt_centro_}: | ID: 10251/205710

Author: Camacho Torregrosa, Susana

Director: Albert Ros, Francesc Xavier ; Santamaria Navarro, Cristina

Abstract

[EN] Population aging and its progression is a fact that must be addressed for the future health and social well-being, especially of the elder people, and by extension, of society as a whole. In this sense, frailty, understood as the progressive decline in physiological systems related to age, plays a remarkable role. The study of frailty using the Frail Index-VIG allows patients to be approached in clinical practice with a multidimensional view, thus establishing a situational diagnosis. This thesis is composed of two different parts. A non-parametric analysis is carried out using the Kaplan-Meier method of the sociodemographic and clinical variables to determine the prognostic factors of frailty according to the Frail-VIG Index, frailty according to the Short Physical Performance Battery, dependency for basic activities of the daily life, and mortality. Subsequently, multivariate analysis were performed using the Cox regression model. For the development of the models, we follow the strategy suggested by Collett. Previously, validation of the Frail-VIG Index is carried out regarding the Short Physical Performance Battery. Regarding the non-parametric analysis, marital status, chronicity level and number of cohabitants, were prognostic factors for frailty according to the Frail-VIG Index; chronicity level and frailty according to the Frail-VIG Index were prognostic factors for frailty according to the Short Physical Performance Battery; prognostic factors for dependency in basic activities of daily living were marital status, frailty according to the Frail-VIG Index and chronicity level; and mortality prognostic factors were dependency for basic activities of daily living, frailty according to the Frail-VIG Index, educational level, marital status, chronicity level and sex. In the multivariate analysis, the variables included in the frailty models using the Frail-VIG Index and dependency for basic activities of daily living were marital status, chronicity level and sex. In the multivariate model of frailty according to the Short Physical Performance Battery, the variables chronicity level and number of cohabitants were significant. And finally, in the multivariate mortality model, the variables level of education, sex and frailty according to the Frail-VIG Index were significant. The Frail Index-VIG presented adequate convergent and discriminative validity compared to the Short Physical Performance Battery. 20% of participants differed in the diagnosis of frailty between both tools, by presenting different profiles. The validation of the Frail-VIG Index has firmed up its use for the development of models. The risk groups might help to establish differentiated health strategies, both at the individual level in the clinical practice and at the population level. In order to facilitate the clinical practice, we developed nomograms that allow an easy visualization of the different risks. (Summary)

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