Motor performance tests as screening instruments for frailty in the older adults

Santos, Kleyton Trindade; Fernandes, Marcos Henrique; Carneiro, José Ailton Oliveira; Coqueiro, Raildo da Silva

doi:10.1016/j.apnr.2016.06.003

Cited by 13 publications

(11 citation statements)

References 28 publications

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“…With regard to the higher prevalence of frailty in women, our results are consistent with those reported in other national and international studies (Fried et al, 2001;Santos-Eggimann et al, 2009). The diagnostic criteria for frailty syndrome are associated with physical condition and are linked with strength and mobility (Santos, Fernandes, Carneiro, & da Silva Coqueiro, 2016), and in this sense, older individuals-especially women-are biologically disadvantaged because they generally have lower muscular mass and strength (Syddall et al, 2009). Another reason is historical culture: it is common for the current generation of women of advanced age to have devoted the majority of their time to family and household care, their lives mainly being spent in more restricted private spaces, and thus they usually present with a worse initial physical condition (Fernandez-Bolaños et al, 2008).…”

Section: Discussionsupporting

confidence: 92%

The impact of biological frailty syndrome on quality of life of nursing home residents

Serrano

Garrido

Fuentes

et al. 2017

Applied Nursing Research

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Increased longevity is a social success that also implicitly entails enormous challenges: adding years to life often implies the management of more geriatric syndromes and higher mortality and disability rates. Although disease and disability are not inevitable consequences of human ageing, the risk of being affected by them considerably increases with age (Baltes & Smith, 2003). The concept of frailty is becoming increasingly relevant in the field of geriatric care, although its precise definition remains disputed (Clegg, Young, Iliffe, Rikkert, & Rockwood, 2013). Ageing is associated with a functional decline; however, its morbidity varies: the decline is faster and leads to increased morbidity and mortality in some individuals, yet others remain robust despite their advanced age. Clinicians and researchers use the notion of frailty to help them understand the heterogeneous nature of human ageing (Zaslavsky, Thompson, & Demiris, 2012) and the literature describes three main theoretical models to explain it. Rockwood and Mitnitski (2011) consider it to be a variable state of health resulting from the accumulation of deficits, Fried et al. (2001) understand it as an interrelated biological syndrome but differentiate it from disease and disability, and Gobbens, Van Assen, Luijkx, and Schols (2012) take a comprehensive view of frailty. The proposal by Fried et al. (2001) has received a broad consensus, is widely used in clinics and in research (Morley et al., 2013; Santos-Eggimann, Cuénoud, Spagnoli, & Junod, 2009), and represents considerable progress in the understanding and exploration the pathophysiology of frailty. They define frailty as a biological syndrome characterized by a decline in reserves and resistance to stressors resulting from an accumulation of deficits in multiple physiological systems, which causes vulnerability and adverse effects on health. The five frailty criteria that they proposed, the "frailty phenotype" (unintentional weight loss, muscular weakness, low energy, slow ambulation speed, and low physical activity) were extensively tested in the Cardiovascular Health Study (CHS). Those with none of the above components were considered as robust, whereas those with one or two components were considered as pre-frail and those with more than two components as frail. The CHS results showed that there was a greater tendency toward frailty in women, as well as an association between frailty and poorer health results: mortality, disability, and hospitalization. Numerous studies later used the same criteria and produced similar results (

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Section: Discussionsupporting

confidence: 92%

The impact of biological frailty syndrome on quality of life of nursing home residents

Serrano

Garrido

Fuentes

et al. 2017

Applied Nursing Research

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“…There were 82 studies published in English [18–99], 9 in Portuguese/BR [100–108], 3 in Japanese [109–111], 1 in Korean [112] and 1 in German [113]. The countries where the participants were most commonly sampled were the USA, with 14 studies [18, 21, 26, 49, 56, 61, 66, 70, 72, 77, 78, 86, 91, 95], Brazil, with 11 studies [64, 83, 92, 100–108], Canada, also with 11 studies [20, 22–24, 39, 54, 71, 80, 93, 94] and the Netherlands with 8 publications [28, 30, 32, 34, 36, 40, 55, 79, 96].…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the duration, some of the instruments were of rapid application (up to 10 minutes), while in some the evaluations are performed in more than one stage, which can last several hours. It should be noted that the majority of the publications did not report the application time [20, 22, 23, 29, 32, 36–38, 41–46, 49, 53, 55, 57–59, 63, 64, 66, 68, 69, 93, 97, 109–113].…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the domains present in the frailty assessment instruments, 22 (11- point FI [77], 5-item mFI [95], Continuous Frailty Scale–CFS [91], electronic Frailty Index–eFI [58], Emergency General Surgeries Frailty Index–EGS-FI [61], FiND–Frail Non-Disabled [42], FRAIL Scale [53], Frailty Phenotype [70], Frailty Phenotype Modified [35], Frailty Screening Questionnaire (FSQ) [99], Frailty Trait Scale–FTS [44], Instrumento Multidimensional de Rastreio da Síndrome da Fragilidade –IMSIFI [101], INTER-FRAIL Study Questionnaire [43], LUCAS [113], Modelo Fried adaptado [106], Motor Performance Tests [64], PRISMA-7 [96], Self-Report Frailty Instrument [31], SHARE Frailty Instrument [74], SHARE Frailty Instrument 75+ [48], SOF Frailty Criteria [72], Trauma-Specific Frailty Index (TSFI) [78], UEF Frailty [56]) evaluated only physical aspects such as: slowness, weakness, inactivity, exhaustion, mobility, morbidities, activities of daily living (ADL), instrumental activities of daily living (IADL), functional capacity, signs and symptoms, laboratory exams, balance, gait, muscular strength, resistance, fatigue, physical activity, muscle mass index (MMI), sphincter control, weight loss, pain, falls, communication (vision, hearing), flexibility, hospitalization and use of medications.…”

Section: Resultsmentioning

confidence: 99%

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Instruments for the detection of frailty syndrome in older adults: A systematic review

et al. 2019

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Frailty is a dynamic process in which there is a reduction in the physical, psychological and/or social function associated with aging. The aim of this study was to identify instruments for the detection of frailty in older adults, characterizing their components, application scenarios, ability to identify pre-frailty and clinimetric properties evaluated. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), under registration number CRD42017039318. A total of 14 electronic sources were searched to identify studies that investigated instruments for the detection of frailty or that presented the construction and/or clinimetric evaluation of the instrument, according to criteria established by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). 96 studies were included in the qualitative synthesis: 51 instruments for the detection of frailty were identified, with predominantly physical domains; 40 were constructed and/or validated for use in the older adult community population, 28 only highlighted the distinction between frail and non-frail individuals and 23 presented three or more levels of frailty. The FRAGIRE, FRAIL Scale, Edmonton Frail Scale and IVCF-20 instruments were the most frequently analyzed in relation to clinimetric properties. It was concluded that: (I) there is a large number of instruments for measuring the same construct, which makes it difficult for researchers and clinicians to choose the most appropriate; (II) the FRAGIRE and CFAI stand out due to their multidimensional aspects, including an environmental assessment; however, (III) the need for standardization of the scales was identified, since the use of different instruments in clinical trials may prevent the comparability of the results in systematic reviews and; (IV) considering the different instruments identified in this review, the choice of researchers/clinicians should be guided by the issues related to the translation and validation for their location and the suitability for their context.

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“…We excluded the timed up and go test because it requires a 3-m length of space to perform; it was replaced by a chair stand test (rising from a chair five times). 19) We also excluded IADLs of cooking and cleaning as those activities are not appropriate to assess older Korean men. We replaced these IADLs with "walking to distant destinations".…”

Section: Development Of Kfi-pcmentioning

confidence: 99%

Development of Korean Frailty Index for Primary Care (KFI-PC) and Its Criterion Validity

Won¹,

Lee²,

Lee³

et al. 2020

Ann Geriatr Med Res

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Background: The objective of this study was to develop and validate the Korean Frailty Index for Primary Care (KFI-PC) based on a comprehensive geriatric assessment. Methods: We developed a 54-item KFI-PC comprising 10 standard domains: cognitive status including delirium or dementia; mood; communication including vision, hearing, and speech; mobility; balance; bowel function; bladder function; ability to carry out activities of daily living; nutrition; and social resources. To test its validity, we applied KFI-PC to participants of the Korean Frailty Aging and Cohort Study (KFACS). We analyzed 1,242 participants (mean age, 77.9±3.9 years; 47.2% men) from the KFACS who visited 10 study centers in 2018, after excluding 32 participants with missing data required to assess Fried's physical frailty phenotype. Results: The mean KFI-PC score was 0.17±0.08, ranging from 0.02 to 0.52. The median KFI-PC score was higher in women than in men, and there was a trend toward higher values in older age groups. The prevalence of frailty when applying a generally used frailty index cutoff point of >0.25 was 17.5% in the whole study sample. As a construct validation of KFI-PC, the area under the receiver operating characteristic curve for Fried's physical frailty was 0.921, and the optimal cutoff value to predict frailty phenotype was 0.23. The KFI-PC score also correlated well with physical, cognitive, and psychological functions; nutritional status; disability in activities of daily living; and instrumental activities of daily living. The Cronbach's alpha coefficient of the 54 total items was 0.737. Conclusion: We developed KFI-PC with 53 deficits, including comprehensive geriatric assessment components, and demonstrated the acceptable construct validity and internal consistency of KFI-PC.

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Motor performance tests as screening instruments for frailty in the older adults

Cited by 13 publications

References 28 publications

The impact of biological frailty syndrome on quality of life of nursing home residents

The impact of biological frailty syndrome on quality of life of nursing home residents

Instruments for the detection of frailty syndrome in older adults: A systematic review

Development of Korean Frailty Index for Primary Care (KFI-PC) and Its Criterion Validity

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