Agreement between fragility assessment instruments for older adults registered in primary health care

Abstract

Objective: To assess the level of agreement between the Subjective Frailty Assessment (SFA) and Clinical Functional Vulnerability Index (CFVI-20) for the diagnosis of frailty in older adults. Methods: A descriptive, comparative, cross-sectional study was conducted in 2018/2019 with 492 older adults at nine Family Health Strategy units in the city of Três Lagoas, state of Mato Grosso do Sul, Brazil. Frailty was assessed using the SFA and CFVI-20 in addition to a structured interview. The Wilcoxon test and Pearson's chi-squared test were used for the comparisons. Results: Agreement was 35.4%, with a Kappa coefficient of 0.11. After dichotomizing the sample into frail and non-frail individuals, agreement was 70.1%, with a Kappa coefficient of 0.41 and Cronbach's alpha coefficients of 0.61 and 0.74 for IVCF-20 and SFA, respectively. The prevalence of frailty was lower using the IVCF-20 (17.1%) compared to 59.8% using the SFA. Conclusion: Agreement regarding the classification of frailty between the two instruments ranged from low to moderate. This finding underscores the need for a standardized instrument for measuring frailty in community-dwelling older adults.

Frailty in community-dwelling older adults: a comparative study of screening instruments

“…The results, however, differ from those of a previous study assessing the level of agreement between the Clinical Functional Vulnerability Index (CFVI-20) and another screening instrument, the Subjective Frailty Assessment (SFA). The results of the cited study showed low-to-moderate agreement, underscoring the need for a standardized instrument for measuring frailty in community-dwelling older adults and the risk of bias in using instruments with subjective assessment components 21 .…”