COVID-19 in long-term care facilities in Brazil: serological survey in a post-outbreak setting

Abstract

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The FRAIL-NH Scale: Systematic Review of the Use, Validity and Adaptations for Frailty Screening in Nursing Homes

“…The FRAIL-NH scale was applied in studies across 20 countries; the majority in Australia (n=14) ( 21 – 34 ), followed by China (n=6) ( 35 – 40 ), Spain (n=3) ( 41 – 43 ), United States (US) (n=3) ( 44 – 46 ), Brazil (n=2) ( 47 , 48 ), Japan (n=2) ( 49 , 50 ), Singapore (n=2) ( 51 , 52 ), Belgium (n=1) ( 53 ), Canada (n=1) ( 54 ), England (n=1) ( 50 ), Europe and Israel (n=1) ( 55 ), France (n=1) ( 56 ), Hong Kong (n=1) ( 57 ), Italy (n=1) ( 58 ), South Korea (n=1) ( 59 ), and Taiwan (n=1) ( 60 ). One study was an international multicenter study based on data from the Services and Health for Elderly in Long TERm care (SHELTER) study, conducted in 8 countries including Czech Republic, England, Finland, France, Germany, Israel, Italy, and the Netherlands ( 55 ).…”

“…When applying these definitions, between 15.1% and 79.5% of residents were frail, while 28.5% to 75.0% of residents were most frail. Other common cut-offs used to define frailty were ≥6 (n=5) ( 39 , 42 , 43 , 48 , 60 ) and ≥8 (n=8) ( 37 , 44 – 47 , 54 , 55 , 58 ). Ten studies assessed the sensitivity and specificity of different cut-offs ( 24 , 29 , 35 – 40 , 47 , 52 ), with ≥8 having the highest sensitivity (94.1%) and specificity (82.8%) for classifying residents as frail based on FI ( 37 ), while two studies reported an optimal cut-off of ≥2 using FI and FP, respectively ( 29 , 40 ).…”

“…By 6 months, those with severe impairment were over twice as likely to be frail ( 45 ). Other applications of FRAIL-NH include: establishing baseline comparability of participants in studies ( 24 , 27 , 28 , 32 , 33 , 54 ); baseline screening as proxy to physical health for RCT recruitment ( 50 ); describing COVID-19 seroprevalence in frail residents ( 48 ); characterizing frailty status in residents interviewed on perceptions of frailty ( 21 , 34 ); examining changes in FRAIL-NH scores at annual routine screening ( 46 ); and the prospective use of FRAIL-NH in acute care ( 52 ).…”

“…Of the 18 cross-sectional studies, 15 studies provided clear inclusion criteria (Table S3) ( 22 – 24 , 29 , 31 , 33 , 35 – 38 , 40 , 42 , 43 , 45 , 54 ). All studies described resident characteristics and settings in detail ( 22 – 24 , 29 , 31 , 33 , 35 – 38 , 40 , 42 , 43 , 45 , 48 , 54 , 55 , 60 ). Cross-sectional associations with frailty were not investigated in seven studies ( 24 , 36 – 38 , 40 , 48 , 54 ), therefore criteria related to confounding factors were not assessed in these studies.…”

“…All studies described resident characteristics and settings in detail ( 22 – 24 , 29 , 31 , 33 , 35 – 38 , 40 , 42 , 43 , 45 , 48 , 54 , 55 , 60 ). Cross-sectional associations with frailty were not investigated in seven studies ( 24 , 36 – 38 , 40 , 48 , 54 ), therefore criteria related to confounding factors were not assessed in these studies. Residents with different frailty status were recruited from the same population, free of outcomes at the start of study, and follow-up time was reported in all 14 outcome studies (Table S4) ( 25 , 26 , 30 , 39 , 41 , 44 , 47 , 51 – 53 , 56 – 59 ).…”