Assessing the strengths and weaknesses of the Clinical Frailty Scale through correlation with a frailty index

Moreno-Ariño, Marc; Jiménez, Irene; Gutiérrez, Albert Cartanyà; Morera, J.; Comet, R

doi:10.1007/s40520-019-01450-w

Cited by 30 publications

(20 citation statements)

References 33 publications

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“…Lastly, the degree of correlation between the two instruments that assess frailty as a continuous reality, Frail-VIG index and CFS ( r = 0.66), was similar to previous studies for these two instruments ( r = 0.71) [ 49 ]. This is consistent with published evidence on convergent validity between CFS and other FIs, ranging from 0.59 of the electronic frailty index [ 50 ] to 0.91 of the FI used by Chong et al [ 51 ].…”

Section: Discussionsupporting

confidence: 85%

Reliability, Validity, and Feasibility of the Frail-VIG Index

Torné

Puigoriol

Zabaleta‐del‐Olmo

et al. 2021

IJERPH

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The study aimed to assess the reliability of the scores, evidence of validity, and feasibility of the Frail-VIG index. A validation study mixing hospitalized and community-dwelling older people was designed. Intraclass correlation coefficient (ICC) was used to assess the inter-rater agreement and the reliability. The construct validity of the Frail-VIG index with respect to the Frailty Phenotype (FP) was evaluated by calculating the area under the receiver operating characteristic curve (AUC-ROC). Convergent validity with the Clinical Frailty Scale (CFS) was assessed using Pearson’s correlation coefficients. The feasibility was evaluated by calculating the average time required to administer the Frail-VIG index and the percentage of unanswered responses. A sample of 527 older people (mean age of 81.61, 56.2% female) was included. The inter-rater agreement and test–retest reliability were very strong: 0.941 (95% CI, 0.890 to 0.969) and 0.976 (95% CI, 0.958 to 0.986), respectively. Results indicated adequate convergent validity of the Frail-VIG index with respect to the FP, AUC-ROC 0.704 (95% CI, 0.622 to 0.786), and a moderate to strong positive correlation between the Frail-VIG index and CFS (r = 0.635, 95% CI, 0.54 to 0.71). The Frail-VIG index administration required an average of 5.01 min, with only 0.34% of unanswered responses. The Frail-VIG index is a reliable, feasible, and valid instrument to assess the degree of frailty in hospitalized and community-dwelling older people.

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Section: Discussionsupporting

confidence: 85%

Reliability, Validity, and Feasibility of the Frail-VIG Index

Torné

Puigoriol

Zabaleta‐del‐Olmo

et al. 2021

IJERPH

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“…The frailty of all participants was assessed at recruitment and confirmed at each timepoint thereafter via an interview using the 9-point clinical frailty scale (CFS). 12 In addition, data were derived from the electronic medical records for all participants, including age, sex, vaccine doses and vaccination dates, and comorbidities.…”

Section: Assessmentsmentioning

confidence: 99%

Durability of response to the third dose of the SARS-CoV-2 BNT162b2 vaccine in adults aged 60 years and older: Three-month follow-up

Raz

Stemmer

Leibovici-Weissman

et al. 2021

Preprint

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BACKGROUND Age and frailty are strong predictors of COVID-19 mortality. After the second BNT162b2 dose, immunity wanes faster in older (≥65 years) versus younger adults. The durability of response after the third vaccine is unclear. METHODS This prospective cohort study included healthcare workers/family members ≥60 years who received a third BNT162b2 dose. Blood samples were drawn immediately before (T0), 10-19 (T1), and 74-103 (T2) days after the third dose. Antispike IgG titers were determined using a commercial assay, seropositivity was defined as ≥50 AU/mL. Neutralizing antibody titers were determined at T2. Adverse events, COVID-19 infections, and clinical frailty scale (CFS) levels were documented. RESULTS The analysis included 97 participants (median age, 70 years [IQR, 66-74], 61% women, 58% CFS level 2). IgG titers, which increased significantly from T0 to T1 (medians, 440 AU/mL [IQR, 294-923] and 25,429 [14,203-36,114] AU/mL, respectively; P<0.001), decreased significantly by T2, but all remained seropositive (median, 8,306 AU/mL [IQR, 4595-14,701], P<0.001 vs T1). In a multivariable analysis, only time from the first vaccine was significantly associated with lower IgG levels at T2 (P=0.004). At T2, 60 patients were evaluated for neutralizing antibodies; all were seropositive (median, 1,294 antibody titer [IQR, 848-2,072]). Neutralizing antibody and antispike IgG levels were correlated (R=0.6, P<0.001). No major adverse events or COVID-19 infections were reported. CONCLUSIONS Antispike IgG and neutralizing antibodies levels remain adequate 3 months after the third BNT162b2 vaccine in healthy adults ≥60 years, although the decline in IgG is concerning. A third vaccine dose in this population should be top priority.

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“…First off, we adopted the frailty criteria developed by Fried et al, but other diagnostic approaches are available, such as the Rockwood Clinical Frailty Scale or the IF-VIG, among others. [51][52][53] Although all these approaches purportedly measure the same concept, frailty, we cannot be sure that the results on the validity and reliability of the SarQoL would have been the same if we had applied other diagnostic approaches. Secondly, our sample of robust, pre-frail, and frail participants is not necessarily representative of frailty in the wider community.…”

Section: Discussionmentioning

confidence: 99%

Evaluating quality of life in frailty: applicability and clinimetric properties of the SarQoL^® questionnaire

Geerinck

Locquet

Bruyère

et al. 2021

J cachexia sarcopenia muscle

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Background The SarQoL® questionnaire was specifically designed to measure quality of life (QoL) in sarcopenia. Frailty and sarcopenia have areas of overlap, notably weak muscle strength and slow gait speed, which may mean that the SarQoL could provide a measure of QoL in frailty. This study aimed to evaluate the clinimetric properties of the SarQoL questionnaire in physical frailty using the Fried criteria. Methods Analyses were carried out on data from the Sarcopenia and Physical impairment with advancing Age study. Frailty was assessed with the Fried criteria and QoL with the SarQoL, the Short-Form 36-Item, and the EuroQoL 5-Dimension (EQ-5D) questionnaires. We evaluated discriminative power (with the Kruskal-Wallis analysis of variance test), internal consistency (with Cronbach's alpha), construct validity (through hypotheses testing), test-retest reliability (with the intraclass correlation coefficient), measurement error (calculating standard error of measurement and smallest detectable change), and responsiveness (through hypotheses testing and standardized response mean). Results In total, 382 participants were included for the validation and 117 for the responsiveness evaluation. They had a median age of 73 (69-79) years, took 5 (3-8) drugs, and had 4 (3-5) co-morbidities. There were more women (n = 223; 58.4%) than men and, in total, 172 (45%) robust, 167 (44%) pre-frail, and 43 (11%) frail participants. Discriminative power was confirmed when significantly lower (P < 0.001) overall SarQoL scores, and thus also worse QoL, were observed between robust [77.1 (64.35-85.90)], pre-frail [62.54 (53.33-69.57)], and frail [49.99 (40.45-56.06)] participants. Six of the SarQoL domains performed likewise, with significantly lower scores according to frailty status with Domain 7 (fears) being the exception. Internal consistency was good (α = 0.866). Convergent (using Short-Form 36-Item and EQ-5D) and divergent construct validity (using EQ-5D) was confirmed. Test-retest reliability was excellent [intraclass correlation coefficient = 0.918 (0.834-0.961)], with a standard error of measurement of 3.88 and a smallest detectable change of 10.76 points. We found moderate responsiveness when five of the nine hypotheses were confirmed, coupled with a large effect size for the overall SarQoL score (corrected standardized response mean of À1.44). Conclusions The SarQoL questionnaire has adequate clinimetric properties for use with frail patients in clinical practice and trials and could provide data that are more appropriate and detailed than the generic questionnaires currently used.

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Assessing the strengths and weaknesses of the Clinical Frailty Scale through correlation with a frailty index

Cited by 30 publications

References 33 publications

Reliability, Validity, and Feasibility of the Frail-VIG Index

Reliability, Validity, and Feasibility of the Frail-VIG Index

Durability of response to the third dose of the SARS-CoV-2 BNT162b2 vaccine in adults aged 60 years and older: Three-month follow-up

Evaluating quality of life in frailty: applicability and clinimetric properties of the SarQoL^® questionnaire

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Assessing the strengths and weaknesses of the Clinical Frailty Scale through correlation with a frailty index

Cited by 30 publications

References 33 publications

Reliability, Validity, and Feasibility of the Frail-VIG Index

Reliability, Validity, and Feasibility of the Frail-VIG Index

Durability of response to the third dose of the SARS-CoV-2 BNT162b2 vaccine in adults aged 60 years and older: Three-month follow-up

Evaluating quality of life in frailty: applicability and clinimetric properties of the SarQoL® questionnaire

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Evaluating quality of life in frailty: applicability and clinimetric properties of the SarQoL^® questionnaire