Comparison of geriatric assessment tools for frailty among community elderly

Abstract

Background Frailty is an important condition in elderly individuals because it increases disability, morbidity, and mortality. The definition frailty from the Cardiovascular Health Study (CHS) criteria is used worldwide and defined as fulfilling 3 out of the 5 phenotypic criteria that indicate compromised energetics: weakness, slowness, low level of physical activity, self-reported exhaustion, and unintentional weight loss. Objective This research aims to study the validity of 5 screening methods, e.g., Clinical Frailty Scale, simple FRAIL questionnaire, PRISMA-7 questionnaire, Time Up and Go Test (TUG), and Gérontopôle frailty screening tool (GFST), and compare those results with the definition of frailty by using the CHS criteria for screening frailty. Methods We conducted a cross-sectional study. The sample was 214 elderly individuals, aged ≥60 years, and living in the community. We used 5 screening tests and the Fried phenotype (CHS criteria) as a reference standard. Analysis of the sensitivity, specificity, PPV, NPV, LR+, LR-, and accuracy of each screening was compared with the Fried phenotype (CHS criteria). Results The prevalence of frailty of elderly individuals in the community was 11.7% when using the Fried phenotype (CHS criteria). The Clinical Frailty Scale has sensitivity 56%, specificity 98.41%, PPV 82.35%, NPV 94.42%, LR+ 35.28, LR- 0.45, and accuracy 93.46%. The simple FRAIL questionnaire has sensitivity 88%, specificity 85.71%, PPV 44.90%, NPV 98.18%, LR+ 6.61, LR- 0.14, and accuracy 85.98%. The PRISMA-7 questionnaire has sensitivity 76%, specificity 86.24%, PPV 42.22%, NPV 96.45%, LR+ 5.52, LR- 0.28, and accuracy 85.05%. TUG has sensitivity 72%, specificity 82.54%, PPV 35.29%, NPV 95.71%, LR+ 4.12, LR- 0.34, and accuracy 81.31%. The GFST has sensitivity 88%, specificity 83.56%, PPV 41.51%, NPV 98.14%, LR+ 5.37, LR- 0.14, and accuracy 84.11%. Conclusions The simple FRAIL questionnaire and GFST have the highest sensitivity compared with the CHS criteria. All screening tests in this study have an accuracy of more than 80% compared with the CHS criteria.

Accuracy of functional tests to identify frail community elderly

“…Previous studies have shown that the TUG test is a good predictor of frailty identification. A cut-off point of 10 seconds for the TUG test was observed in some studies (Savva et al, 2013, Sukkriang et al, 2020, Ambagtsheer et al, 2020 with sensitivity of 72.0% and specificity of 82.54% obtained by Sukkriang et al, (2020) 2017) suggested a cut-off point of eight seconds, with AUC of 0.775, sensitivity of 85.0%, specificity of 59.5%. Methodological differences, such as sample size and study design, may justify the divergence of the findings.…”

“…However, which is the best cut-off point to identify frail older adults is still uncertain. Most studies have cut-off points above 10 seconds for the identification of frail older adults (Savva et al, 2013, Walston, Buta et al, 2018, Sukkriang et al, 2020.…”

Prevalence of Frailty in the Middle East: Systematic Review and Meta-Analysis

“…In addition, the paucity of studies in the Middle East, in general, makes an uncertain assessment of frailty in the Middle East region. More studies are needed examining the net contribution of frailty screening to risk prediction in different settings and populations, and for both clinical and patient-centered outcomes [ 31 ].…”

Development of Algorithms for Automated Timed Up-and-Go Test Subtask and Step Frequency Analysis

“…The growth in life expectancy in the past decades has led to increasing frailty, which is a risk factor for many diseases [1]. To prevent the associated negative health outcomes, an early identification of the frailty signs and symptoms is needed.…”