{"doi":"10.1093/gerona/glab071","title":"Updating and Validating the U.S. Veterans Affairs Frailty Index: Transitioning From ICD-9 to ICD-10","abstract":"BACKGROUND: The Veterans Affairs Frailty Index (VA-FI) is an electronic frailty index developed to measure frailty using administrative claims and electronic health records data in Veterans. An update to ICD-10 coding is needed to enable contemporary measurement of frailty. METHOD: International Classification of Diseases, ninth revision (ICD-9) codes from the original VA-FI were mapped to ICD-10 first using the Centers for Medicaid and Medicare Services (CMS) General Equivalence Mappings. The resulting ICD-10 codes were reviewed by 2 geriatricians. Using a national cohort of Veterans aged 65 years and older, the prevalence of deficits contributing to the VA-FI and associations between the VA-FI and mortality over years 2012-2018 were examined. RESULTS: The updated VA-FI-10 includes 6422 codes representing 31 health deficits. Annual cohorts defined on October 1 of each year included 2 266 191 to 2 428 115 Veterans, for which the mean age was 76 years, 97%-98% were male, 78%-79% were White, and the mean VA-FI was 0.20-0.22. The VA-FI-10 deficits showed stability before and after the transition to ICD-10 in 2015, and maintained strong associations with mortality. Patients classified as frail (VA-FI > 0.2) consistently had a hazard of death more than 2 times higher than nonfrail patients (VA-FI ≤ 0.1). Distributions of frailty and associations with mortality varied with and without linkage to CMS data and with different assessment periods for capturing deficits. CONCLUSIONS: The updated VA-FI-10 maintains content validity, stability, and predictive validity for mortality in a contemporary cohort of Veterans aged 65 years and older, and may be applied to ICD-9 and ICD-10 claims data to measure frailty.","journal":"The Journals of Gerontology Series A","year":2021,"id":149070,"datarank":3.9831145024888626,"base_score":4.736198448394496,"endowment":4.736198448394496,"self_citation_contribution":0.7104297672591745,"citation_network_contribution":3.272684735229688,"self_endowment_contribution":0.7104297672591745,"citer_contribution":3.272684735229688,"corpus_percentile":94.42252649493308,"corpus_rank":722,"citation_count":113,"citer_count":88,"citers_with_citation_signal":63,"citers_with_endowment":63,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.85,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":336511,"name":"Clark DuMontier","orcid":"0000-0003-2582-7816","position":1,"is_corresponding":false},{"id":634330,"name":"Cenk Yildirim","orcid":"0000-0001-5615-3936","position":2,"is_corresponding":false},{"id":635486,"name":"Brian Charest","orcid":null,"position":3,"is_corresponding":false},{"id":268192,"name":"Chelsea E. Hawley","orcid":"0000-0002-6136-8189","position":4,"is_corresponding":false},{"id":634331,"name":"Min Zhuo","orcid":"0000-0002-0785-3183","position":5,"is_corresponding":false},{"id":268198,"name":"Julie M. Paik","orcid":"0000-0002-1315-5445","position":6,"is_corresponding":false},{"id":634332,"name":"Enzo Yaksic","orcid":"0000-0002-9844-7518","position":7,"is_corresponding":false},{"id":11341,"name":"J. Michael Gaziano","orcid":"0000-0002-5384-9767","position":8,"is_corresponding":false},{"id":56409,"name":"Nhan V. Do","orcid":"0000-0001-6868-7011","position":9,"is_corresponding":false},{"id":11348,"name":"Mary T. Brophy","orcid":"0000-0003-2314-4368","position":10,"is_corresponding":false},{"id":11349,"name":"Kelly Cho","orcid":"0000-0003-1727-7076","position":11,"is_corresponding":false},{"id":270250,"name":"Dae Hyun Kim","orcid":"0000-0001-7290-6838","position":12,"is_corresponding":false},{"id":634333,"name":"Jane A. Driver","orcid":"0000-0001-9759-4607","position":13,"is_corresponding":false},{"id":56417,"name":"Nathanael R. Fillmore","orcid":"0000-0002-8058-3423","position":14,"is_corresponding":false},{"id":341309,"name":"Ariela R. Orkaby","orcid":"0000-0002-4297-6306","position":15,"is_corresponding":false},{"id":499572,"name":"David Cheng","orcid":"0000-0002-2816-6585","position":0,"is_corresponding":true}],"reference_count":53,"raw_metadata":null,"created_at":"2026-07-18T23:42:51.282401Z","pmid":"33693638","pmcid":"PMC8202143","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}