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However, it remains unclear whether the frailty\u2010delirium relationship differs by measurement tool (e.g., frailty index vs. frailty phenotype) and whether frailty is associated with delirium, independent of preoperative cognition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We used the successful aging after elective surgery (SAGES) study, a prospective cohort of older adults age \u226570 undergoing major non\u2010cardiac surgery (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009505). Preoperative measurement of the modified mini\u2010mental (3MS) test, frailty index and frailty phenotype were obtained. The confusion assessment method (CAM), supplemented by chart review, identified postoperative delirium. Delirium feature severity was measured by the sum of CAM\u2010severity (CAM\u2010S) scores. Generalized linear models were used to determine the relative risk of each frailty measure with delirium incidence and severity. Subsequent models adjusted for age, sex, surgery type, Charlson comorbidity index, and 3MS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      On average, patients were 76.7\u2009years old (standard deviation 5.22), 58.8% of women. For the frailty index, the incidence of delirium was 14% in robust, 17% in prefrail, and 31% in frail patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). For the frailty phenotype, delirium incidence was 13% in robust, 21% in prefrail, and 27% in frail patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016). Frailty index, but not phenotype, was independently associated with delirium after adjustment for comorbidities (relative risk [RR] 2.13, 95% confidence interval [CI] 1.23\u20133.70; RR 1.61, 95% CI 0.77\u20133.37, respectively). Both frailty measures were associated with delirium feature severity. After adjustment for preoperative cognition, only the frailty index was associated with delirium incidence; neither index nor phenotype was associated with delirium feature severity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both the frailty index and phenotype were associated with the development of postoperative delirium. The index showed stronger associations that remained significant after adjusting for baseline comorbidities and preoperative cognition. Measuring frailty prior to surgery can assist in identifying patients at risk for postoperative delirium.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.18677","type":"journal-article","created":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T15:20:57Z","timestamp":1700061657000},"page":"1781-1792","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Comparison of the frailty index and frailty phenotype and their associations with postoperative delirium incidence and severity"],"prefix":"10.1111","volume":"72","author":[{"given":"Stacie G.","family":"Deiner","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Dartmouth Health  Lebanon New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward R.","family":"Marcantonio","sequence":"additional","affiliation":[{"name":"Division of General Medicine, Department of Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Gerontology, Department of Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shrunjal","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Division of General Medicine, Department of Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon K.","family":"Inouye","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Gerontology, Department of Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts USA"},{"name":"Aging Brain Center, Hinda and Arthur Marcus Institute for Aging Research Hebrew SeniorLife  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas G.","family":"Travison","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Gerontology, Department of Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts USA"},{"name":"Aging Brain Center, Hinda and Arthur Marcus Institute for Aging Research Hebrew SeniorLife  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva M.","family":"Schmitt","sequence":"additional","affiliation":[{"name":"Aging Brain Center, Hinda and Arthur Marcus Institute for Aging Research Hebrew SeniorLife  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tammy","family":"Hshieh","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Aging Brain Center, Hinda and Arthur Marcus Institute for Aging Research Hebrew SeniorLife  Boston Massachusetts USA"},{"name":"Division of Aging, Department of Medicine Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara G.","family":"Fong","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Aging Brain Center, Hinda and Arthur Marcus Institute for Aging Research Hebrew SeniorLife  Boston Massachusetts USA"},{"name":"Department of Neurology Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long H.","family":"Ngo","sequence":"additional","affiliation":[{"name":"Division of General Medicine, Department of Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Biostatistics Harvard T. 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