Development and Validation of a Self-Administered Multidimensional Prognostic Index to Predict Negative Health Outcomes in Community-Dwelling Persons

The multidimensional prognostic index (MPI) is a comprehensive geriatric assessment(CGA)-based tool that ac-curately predicts negative health outcomes in older subjects with different diseases and settings. To calculate the MPIseveral validated tools are assessed by health care professionals according to the CGA, whereas self-reported infor-mation by the patients is not available, but it could be of importance for the early identification of frailty. We aimed todevelop and validate a self-administered MPI (SELFY-MPI) in community-dwelling subjects. For this reason, weenrolled 167 subjects (mean age=67.3, range=20–88 years, 51%=men). All subjects underwent a CGA-basedassessment to calculate the MPI and the SELFY-MPI. TheSELFY-MPI included the assessment of (1) basic andinstrumental activities of daily living, (2) mobility, (3) memory, (4) nutrition, (5) comorbidity, (6) number of medi-cations, and (7) socioeconomic situation. The Bland–Altman methodology was used to measure the agreementbetween MPI and SELFY-MPI. The mean MPI and SELFY-MPI values were 0.147 and 0.145, respectively. The meandifference was+0.002–standard deviation of 0.07. Lower and upper 95% limits of agreement were-0.135 and+0.139, respectively, with only 5 of 167(3%) of observations outsidethe limits. Stratified analysis by age providedsimilar results for younger (£65 years old,n=45) and older subjects (>65 years,n=122). The analysis of variances insubjects subdivided according to different year decades showed no differences of agreement according to age. Inconclusion, the SELFY-MPI can be used as a prognostic tool in subjects of different ages.