A Comparison of Frailty Assessment Instruments in Different Clinical and Social Care Settings: The Frailtools Project

Oviedo-Briones, Myriam; Laso, Ángel Rodríguez; Carnicero, José Antonio Carranza; Cesari, Matteo; Grodzicki, Tomasz; Gryglewska, Barbara; Sinclair, Alan J.; Landi, Francesco; Vellas, Bruno; Checa-López, Marta; Rodríguez‐Mañas, Leocadio

doi:10.1016/j.jamda.2020.09.024

Cited by 57 publications

(50 citation statements)

References 32 publications

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“…Although significant strides have been made in understanding the frailty syndrome, challenges in defining and diagnosing this condition persist, with a recent study noting low concordance among various assessment tools. 35,36 Increasing interest in coding-based instruments that can quickly identify frail individuals from electronic medical records, such as the Johns Hopkins Adjusted Clinical Groups, necessitates appreciation of the ambiguity behind the term "frailty." 37 Although the concepts of disability and comorbidity are inherently related to frailty and are often interchanged, these entities remain distinct conditions that may benefit from different targeted interventions.…”

Section: Discussionmentioning

confidence: 99%

Association of Frailty with Perioperative Outcomes Following Hepatic Resection: A National Study

Madrigal

Hadaya

Lee

et al. 2022

Journal of the American Medical Directors Association

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Section: Discussionmentioning

confidence: 99%

Association of Frailty with Perioperative Outcomes Following Hepatic Resection: A National Study

Madrigal

Hadaya

Lee

et al. 2022

Journal of the American Medical Directors Association

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“…In geriatric wards, frailty prevalence between 50% and 75% has been reported. 17,18 Also, several previous studies in other geriatric patient populations reported that frailty prevalence differs according to the frailty instrument used and demonstrated limited agreement. 18e21 Our study reports that frailty seems to be a useful predictor for nonhome discharge in geriatric rehabilitation inpatients.…”

Section: Discussionmentioning

confidence: 98%

Ability of 3 Frailty Measures to Predict Short-Term Outcomes in Older Patients Admitted for Post-Acute Inpatient Rehabilitation

Stuck

Mangold

Wittwer

et al. 2022

Journal of the American Medical Directors Association

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Objectives: To evaluate the ability of 3 commonly used frailty measures to predict short-term clinical outcomes in older patients admitted for post-acute inpatient rehabilitation. Design: Observational cohort study. Setting and Participants: Consecutive patients (n ¼ 207) admitted to a geriatric inpatient rehabilitation facility. Methods: Frailty on admission was assessed using a frailty index, the physical frailty phenotype, and the Clinical Frailty Scale (CFS). Predictive capacity of the frailty instruments was analyzed for (1) nonhome discharge, (2) readmission to acute care, (3) functional decline, and (4) prolonged length of stay, using multivariate logistic regression models and receiver operating characteristic (ROC) curves. Results: The number of patients classified as frail was 91 (44.0%) with the frailty index, 134 (64.7%) using the frailty phenotype, and 151 (73.0%) with the CFS. The 3 frailty measures revealed acceptable discriminatory accuracy for nonhome discharge (area under the curve ! 0.7) but differed in their predictive ability: the adjusted odds ratio (OR) for nonhome discharge was highest for the CFS [6.2, 95% confidence interval (CI) 1.8-21.1], compared to the frailty index (4.1, 95% CI 2.0-8.4) and the frailty phenotype (OR 2.9, 95% CI 1.2-6.6). For the other outcomes, discriminatory accuracy based on ROC tended to be lower and predictive ability varied according to frailty measure. Readmission to acute care from inpatient rehabilitation was predicted by all instruments, most pronounced by the frailty phenotype (OR 5.4,) and the frailty index (OR 2.5, 95% CI 1.1-5.6), and less so by the CFS (OR 1.4, 95% CI 0.5-3.8). Conclusions and Implications: Frailty measures may contribute to improved prediction of outcomes in geriatric inpatient rehabilitation. The choice of the instrument may depend on the individual outcome of interest and the corresponding discriminatory ability of the frailty measure.

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“…Many scales have been developed to measure frailty in patient cohorts. The Clinical Frailty Scale (CFS) is a frailty scale that has high feasibility for use for assessment of frailty in primary care given its short time for assessment [19]. The CFS has been shown to correlate well with an increased risk of falls [20].…”

Section: Introductionmentioning

confidence: 99%

Factors influencing fear of falling in community-dwelling older adults in Singapore: a cross-sectional study

Roza¹,

Ng²,

Mathew³

et al. 2022

BMC Geriatr

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Background Fear of falling (FoF) has far-reaching implications including activity restriction, functional decline and reduced quality of life. It is a common consequence of falls but may be present even in non-fallers. This study aimed to determine the factors associated with FoF in a segment of Singapore’s community-dwelling older adults. Methods This descriptive cross-sectional study recruited a convenience sample of adults aged 65 and above from 4 primary care clinics from September 2020 to March 2021. Data were collected on demographic factors, clinical factors such as multi-morbidity, falls characteristics such as history of falls, injuries, and reasons for falls and frailty as determined by the Clinical Frailty Scale (CFS). FoF was measured using the Short Falls Efficacy Scale–International (Short FES-I), cut-off score of 14 and above indicated high FoF. Logistic regression was used to determine factors associated with high FoF. Results Out of 360 older adults, 78.1% were Chinese and 59.7% females. The mean age was 78.3 years and 76 (21.1%) had a history of falls in the past six months. Almost half (43.1%) were mildly to moderately frail and most (80.6%) had multi-morbidity. The mean FoF score was 15.5 (SD 5.97) and 60.8% reported high FoF. There were statistically significant differences in age, gender, ethnicity, marital status, educational level, use of walking aid, multi-morbidity, frailty status, history of falls within six months and reason for falls between patients who had high FoF versus those who had moderate or low FoF. Logistic regression found that Malay ethnicity (OR = 5.81, 95% CI 1.77–19.13), marital status, use of walking aids (OR = 3.67, 95% CI = 1.54–8.77) and frailty were significant factors associated with high FoF. Compared to those who were never married, the odds of high FoF were significantly higher in married older adults (OR = 6.75, 95% CI 1.39 to 32.76), those who were separated or divorced (OR 10.40, 95% CI 1.13 to 95.76) and those who were widowed (OR = 7.41, 95% CI 1.51 to 36.41). Compared to well older adults, the odds of high FoF were significantly higher in pre frail older adults (OR = 6.87, 95% CI = 2.66–17.37), mildly frail older adults (OR = 18.58, 95% CI = 4.88–70.34) and moderately frail older adults (OR = 144.78, 95% CI = 13.86–1512.60). Conclusions The study found that pre frail to moderately frail older adults as determined by CFS have significantly higher risk of high FoF. The demographic factors such as marital status and ethnicity and falls characteristics associated with FoF in this study will be helpful to develop targeted and tailored interventions for FoF.

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A Comparison of Frailty Assessment Instruments in Different Clinical and Social Care Settings: The Frailtools Project

Cited by 57 publications

References 32 publications

Association of Frailty with Perioperative Outcomes Following Hepatic Resection: A National Study

Association of Frailty with Perioperative Outcomes Following Hepatic Resection: A National Study

Ability of 3 Frailty Measures to Predict Short-Term Outcomes in Older Patients Admitted for Post-Acute Inpatient Rehabilitation

Factors influencing fear of falling in community-dwelling older adults in Singapore: a cross-sectional study

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