What is the Multidimensional Prognostic Index (MPI)

The Multidimensional Prognostic Index is a prognostic tool based on the Comprehensive Geriatric
Assessment (CGA), which is the gold standard for the assessment of elderly people (aged≥65 years).
Numerous studies in literature suggest the excellent accuracy and calibration of the MPI in predicting short-
and long-term negative outcomes, like hospitalization, institutionalization, and mortality.

Which domains are included in the Multidimensional Prognostic
Index (MPI)
The MPI tool investigates the health of the elderly person from a multidimensional perspective including 8
different domains: basal and instrumental activities of daily living, mobility or risk of injury from pressure,
cognitive status, nutrition status, co-morbidities, number of medications taken, and co-habitation status.

Which MPI tools exist
Over the years, different versions of the MPI have been developed, according to the contest and purpose of
use, corresponding to:
Hospital MPI (which can be used in hospitalization),
Outpatient MPI (for outpatient settings),
MPI-SVaMA (based on the Multidimensional Evaluation Sheet for Adults and Seniors)
ONCO-MPI (used in oncology)
TELE-MPI (can be done remotely)
Brief-MPI (brief version for screening contests),
SELFY-MPI (self-administering version “EFFICHRONIC”),
SELFY-MPI-SF (brief self-administering version, “Short Form” )
SELFY-Brief-MPI ( brief self-administering version for screening contests).

All the different versions of the MPI will be presented in this manual, along with the related descriptions of
the rating scales and instructions on how to compile, calculate and interpret the MPI score obtained.

MPI user manual

How to use the Portable-MPI?
With the link presented on this page, it is possible to download an application for Windows and Mac OS X, containing all the MPI tools presented, in all currently available languages (being updated). The software gives you the possibility to fill in the MPI in the preferred version, and save it in .pdf format directly in your PC or Mac, for future consultation.
The application does NOT save the data in any way.

Interpretation of results?
If the index obtained is a value between 0 and 0.33 the prognostic frail risk is considered low; if the value is between 0.34 and 0.66 the prognostic frail risk is considered moderate; if the value is between 0.67 and 1.00 the prognostic frail risk is considered severe.

System requirements:

OS requirements

Windows

• Windows 7 and later are supported, older operating systems are not supported (and do not work).
• Both x86 and amd64 (x64) binaries are provided for Windows. Please note, the ARM version of Windows is not supported for now.

Mac

• Only 64bit binaries are provided for macOS, and the minimum macOS version supported is macOS 10.10 (Yosemite).
• Native support for Apple Silicon (arm64) devices was added in Electron 11.0.0.

Hardware requirements:

Windows

• An Intel Pentium 4 processor or later that's SSE2 capable
• 512 MB of RAM

Mac

• An Intel processor that's 64-bit
• 512 MB of RAM

For Mac OS X:

MPI-MAC

For Windows

MPI-WINDOWS

References

1. Pilotto A, Ferrucci L, Franceschi M et al. Development and Validation of a Multidimensional Prognostic Index for One-Year Mortality from Comprehensive Geriatric Assessment in Hospitalized Older Patients. Rejuvenation Res. 2008;11:151-161.

2. Pilotto A, Addante F, Ferrucci L et al. The Multidimensional Prognostic Index (MPI) predicts short and long-term mortality in older patients with community-acquired pneumonia. J Gerontol A Biol Med Sci. 2009;64:880-887.

3. Pilotto A, Addante F, Franceschi M et al. A Multidimensional Prognostic Index (MPI) based on a comprehensive geriatric assessment predicts short-term mortality in older patients with heart failure. Circ Heart Fail 2010; 3: 14-20.

4. Schocken DD. Prognosis of Heart Failure in the Elderly. Not an Affair of the Heart? Circ Heart Fail 2010; 3: 2-3.

5. Pilotto A, Addante F, D’Onofrio G, Sancarlo D, Ferrucci L. The Comprehensive Geriatric Assessment and the multidimensional approach. A new look at the older patient with gastroenterological disorders. Best Pract Res Clin Gastroenterol 2009;23: 829-37.

6. Pilotto A, Sancarlo D, Panza et al. The Multidimensional Prognostic Index (MPI) Based on a Comprehensive Geriatric Assessment Predicts Short- and Long-term Mortality in Hospitalized Older Patients with Dementia. J Alzheimers Dis. 2009;18: 191-9.

7.Veronese N et al. Prevalence of multidimensional frailty and pre-frailty in older people in different settings: A systematic review and meta-analysis. Ageing Res Rev. 2021 Oct 23;72:101498. doi: 10.1016/j.arr.2021.101498

8. Custodero C et al. Validation and implementation of telephone-administered version of the Multidimensional Prognostic Index (TELE-MPI) for remote monitoring of community-dwelling older adults.
Aging Clin Exp Res. 2021 May 18:1-7. doi: 10.1007/s40520-021-01871-6

9. Mattace-Raso F, Pilotto A. The challenge of the multifaceted prognosis in the older people and the Multidimensional Prognostic Index. Eur Geriatr Med. 2021 Apr;12(2):223-226. doi: 10.1007/s41999-021-00457-9

10. Goudzwaard JA et al. Multidimensional Prognostic Index and Outcomes in Older Patients Undergoing Transcatheter Aortic Valve Implantation: Survival of the Fittest. J Clin Med. 2021 Aug 11;10(16):3529. doi: 10.3390/jcm10163529

11. Pilotto A et al. A multidimensional approach to frailty in older people. Ageing Res Rev. 2020 Jul;60:101047

12. Cruz-Jentoft AJ et al. MPI_AGE Investigators. Using the Multidimensional Prognostic Index (MPI) to improve cost-effectiveness of interventions in multimorbid frail older persons: results and final
recommendations from the MPI_AGE European Project. Aging Clin Exp Res.2020 May;32(5):861-868.

13. Pata G et al. Multidimensional Prognostic Index (MPI) score has the major impact on outcome prediction in elderly surgical patients with colorectal cancer: The FRAGIS study. J Surg Oncol 2020 Nov 25. doi: 10.1002/jso.26314

14. Meyer AM et al. The Multidimensional Prognostic Index in general practice: One-year follow-up study. Int J Clin Pract. 2019 Aug 13:e13403. doi: 10.1111/ijcp.13403

15. Pilotto A et al. Development and validation of a self-administered Multidimensional Prognostic Index (SELFY-MPI) to predict negative health outcomes in community-dwelling persons. Rejuvenation Res. 2019; 22 (4): 299-305

15. Dent E et al. Management of frailty: opportunities, challenges, and future directions. Lancet 2019;394:1376-1386; doi: 10.1016/S0140-6736(19)31785-4

16. Pilotto A et al. MPI_AGE Investigators.  Using the Multidimensional Prognostic Index to Predict Clinical Outcomes of Hospitalized Older Persons: a Prospective, Multicentre, International Study. J Gerontol A Biol Sci Med Sci. 2019; 74 (10): 1643-1649

17. Giantin V et al. Performance of the Multidimensional Geriatric Assessment and Multidimensional Prognostic Index in predicting negative outcomes in older adults with cancer. Eur J Cancer Care 2018; 27 doi: 10.1111/ecc.12585

18. Warnier RM et al. Validity, Reliability and Feasibility of Tools to Identify Frail Older Patients in Inpatient Hospital Care: A Systematic Review. J Nutr Health Aging 2016; 20, 218-230 

19. Volpato S et al. Change in the Multidimensional Prognostic Index Score During Hospitalization in Older Patients. Rejuvenation Res. 2016 Jun;19(3):244-51

20. Angleman SB et al. on behalf of the MPI_AGE Project Investigators. Multidimensional Prognostic Index in Association with Future Mortality and Number of Hospital Days in a Population-Based Sample of Older Adults: Results of the EU Funded MPI_AGE Project. PLOS ONE July 29, 2015; DOI:10.1371/journal.pone.0133789  pages 1/11

21. Volpato S et al. on behalf of the MPI-TriVeneto Study Group. Multidimensional Prognostic Index predicts mortality and length of stay during hospitalization in the older patients: a multicenter prospective study. J Gerontol A Biol Sci Med Sci 2015; 70 (3): 323-9

22. Pilotto A et al. Perspective: the challenge of clinical decision-making for drug treatment in older people. The role of multidimensional assessment and prognosis. Front Med 2015 Jan 14; 1: 61.
doi 103389/fmed.2014.00061

23. Gallucci M et al. Multidimensional Prognostic Index in a Cognitive Impairment Outpatient Setting: Mortality and Hospitalizations. The Treviso Dementia (TREDEM) Study. J Alzheimer’s Dis 2014; 42: 1461-8

24. Pilotto A et al. on behalf of the FIRI-SIGG Study group. Comparing the prognostic accuracy for all-cause mortality of the Frailty Instruments: a multicentre 1-year follow-up in hospitalized older
patients. PLos One 2012; 7(1): e29090 (1-9)

25. Sancarlo D et al.  Validation of a modified Multidimensional Prognostic Index (m-MPI) including the Mini Nutritional Assessment Short-form (MNA-SF) for the prediction of one-year mortality in
hospitalized elderly patients. J Nutr Health Aging 2011; 15: 169-173.