Validity Properties of a Self-reported Modified Frailty Phenotype Among People With HIV in Clinical Care in the United States

Stephanie A Ruderman; Allison R Webel; Amanda L Willig; Lydia N Drumright; Annette L Fitzpatrick; Michelle C Odden; John D Cleveland; Greer Burkholder; Christine H Davey; Julia Fleming; Thomas W Buford; Raymond Jones; Robin M Nance; Bridget M Whitney; L Sarah Mixson; Andrew W Hahn; Kenneth H Mayer; Meredith Greene; Michael S Saag; Charles Kamen; Chintan Pandya; William B Lober; Mari M Kitahata; Paul K Crane; Heidi M Crane; Joseph A C Delaney

doi:10.1097/JNC.0000000000000389

Validity Properties of a Self-reported Modified Frailty Phenotype Among People With HIV in Clinical Care in the United States

J Assoc Nurses AIDS Care. 2023 Mar-Apr;34(2):158-170. doi: 10.1097/JNC.0000000000000389. Epub 2023 Jan 18.

Affiliation

¹ Stephanie A. Ruderman, MPH, is a PhD candidate, Department of Epidemiology, University of Washington, Seattle, Washington, USA. Allison R. Webel, RN, PhD, is an Associate Dean for Research, School of Nursing, University of Washington, Seattle, Washington, USA. Amanda L. Willig, PhD, RD, is an Associate Professor, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. Lydia N. Drumright, PhD, MPH, is a Clinical Assistant Professor, School of Nursing, University of Washington, Seattle, Washington, USA. Annette L. Fitzpatrick, PhD, is a Research Professor, Department of Epidemiology, University of Washington, Seattle, Washington, USA. Michelle C. Odden, PhD, is an Associate Professor, Department of Epidemiology and Population Health, School of Medicine, Stanford University, Stanford, California, USA. John D. Cleveland, MS, is a Statistician, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA. Greer Burkholder, MD, is an Assistant Professor, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. Christine H. Davey, RN, PhD, is a Postdoctoral Fellow, School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA. Julia Fleming, MD, is an Infectious Disease Specialist, Harvard Medical School, Fenway Institute, Boston, Massachusetts, USA. Thomas W. Buford, PhD, is a Professor, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA and Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham VA Medical Center, Birmingham, Alabama, USA. Raymond Jones, PhD, is an Assistant Professor, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. Robin M. Nance, PhD, is a Research Scientist, School of Medicine, University of Washington, Seattle, Washington, USA. Bridget M. Whitney, PhD, MPH, is a Senior Research Scientist, School of Medicine, University of Washington, Seattle, Washington, USA. L. Sarah Mixson, MPH, is a Research Scientist, School of Medicine, University of Washington, Seattle, Washington, USA. Andrew W. Hahn, MD, is a Clinical Assistant Professor, School of Medicine, University of Washington, Seattle, Washington, USA. Kenneth H. Mayer, MD, is a Professor, Harvard Medical School, Fenway Institute, Boston, Massachusetts, USA. Meredith Greene, MD, is an Associate Professor, Department of Medicine, University of California San Francisco, San Francisco, California, USA. Michael S. Saag, MD, is a Professor and Associate Dean, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. Charles Kamen, PhD, MPH, is an Associate Professor, Department of Surgery, University of Rochester, Rochester, New York, USA. Chintan Pandya, PhD, is an Assistant Scientist, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA. William B. Lober, MD, MS, is a Professor, School of Nursing, University of Washington, Seattle, Washington, USA. Mari M. Kitahata, MD, MPH, is a Professor, School of Medicine, University of Washington, Seattle, Washington, USA. Paul K. Crane, MD, MPH, is a Professor, School of Medicine, University of Washington, Seattle, Washington, USA. Heidi M. Crane, MD, MPH, is a Professor, School of Medicine, University of Washington, Seattle, Washington, USA. Joseph A. C. Delaney, PhD, is an Associate Professor, College of Pharmacy, University of Manitoba, Winnipeg, Manitoba, California, USA.

Abstract

Modifications to Fried's frailty phenotype (FFP) are common. We evaluated a self-reported modified frailty phenotype (Mod-FP) used among people with HIV (PWH). Among 522 PWH engaged in two longitudinal studies, we assessed validity of the four-item Mod-FP compared with the five-item FFP. We compared the phenotypes via receiver operator characteristic curves, agreement in classifying frailty, and criterion validity via association with having experienced falls. Mod-FP classified 8% of PWH as frail, whereas FFP classified 9%. The area under the receiver operator characteristic curve for Mod-FP classifying frailty was 0.93 (95% CI = 0.91-0.96). We observed kappa ranging from 0.64 (unweighted) to 0.75 (weighted) for categorizing frailty status. Both definitions found frailty associated with a greater odds of experiencing a fall; FFP estimated a slightly greater magnitude (i.e., OR) for the association than Mod-FP. The Mod-FP has good performance in measuring frailty among PWH and is reasonable to use when the gold standards of observed assessments (i.e., weakness and slowness) are not feasible.

Publication types

Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Aged
Frail Elderly
Frailty*
Geriatric Assessment
HIV Infections*
Humans
Phenotype
Self Report
United States

Validity Properties of a Self-reported Modified Frailty Phenotype Among People With HIV in Clinical Care in the United States

Authors

Affiliation

Abstract

Publication types

MeSH terms

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