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Type: Journal article
Title: Frailty state utility and minimally important difference: findings from the North West Adelaide Health Study
Author: Thompson, M.Q.
Theou, O.
Ratcliffe, J.
Tucker, G.R.
Adams, R.J.
Walters, S.J.
Visvanathan, R.
Citation: Age and Ageing, 2020; 50(2):565-569
Publisher: Oxford University Press (OUP)
Issue Date: 2020
ISSN: 0002-0729
Statement of
Mark Q. Thompson, Olga Theou, Julie Ratcliffe, Graeme R. Tucker, Robert J. Adams, Stephen J.Walters, Renuka Visvanathan
Abstract: BACKGROUND: frailty is a dynamic condition for which a range of interventions are available. Health state utilities are values that represent the strength of an individual's preference for specific health states, and are used in economic evaluation. This is a topic yet to be examined in detail for frailty. Likewise, little has been reported on minimally important difference (MID), the extent of change in frailty status that individuals consider to be important. OBJECTIVES: to examine the relationship between frailty status, for both the frailty phenotype (FP) and frailty index (FI), and utility (preference-based health state), and to determine a MID for both frailty measures. DESIGN AND SETTING: population-based cohort of community-dwelling Australians. PARTICIPANT: in total, 874 adults aged ≥65 years (54% female), mean age 74.4 (6.2) years. MEASUREMENTS: frailty was measured using the FP and FI. Utilities were calculated using the short-form 6D health survey, with Australian and UK weighting applied. MID was calculated cross-sectionally. RESULTS: for both the FP and FI, frailty was significantly statistically associated (P < 0.001) with lower utility in an adjusted analysis using both Australian and UK weighting. Between-person MID for the FP was identified as 0.59 [standard deviation (SD) 0.31] (anchor-based) and 0.59 (distribution-based), whereas for the FI, MID was 0.11 (SD 0.05) (anchor-based) and 0.07 (distribution-based). CONCLUSIONS: frailty is significantly associated with lower preference-based health state utility. Frailty MID can be used to inform design of clinical trials and economic evaluations, as well as providing useful clinical information on frailty differences that patients consider important.
Keywords: frailty
quality of life
minimally important difference
older adults
Description: Published electronically 16 September 2020
Rights: © The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email:
DOI: 10.1093/ageing/afaa166
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