Predictive validity of PRISMA-7 as a screening instrument for frailty in a hospital setting

Abstract

ObjectivesFrailty is a major clinical geriatric syndrome associated with serious adverse events including functional disability, falls, hospitalisation, increased morbidity and mortality. The aim of this study was to study the associations between frailty defined as Program of Research to Integrate Services for the Maintenance of Autonomy (PRISMA-7) score ≥3 and use of healthcare resources in hospital and in the municipality as well as association between frailty and mortality.DesignRegister-based retrospective study.SettingThe target population consists of patients aged 75 years or above who, during hospital stay, were assessed by a physiotherapist, and at discharge from hospital were prescribed further physical training in the community.Participants973 individuals aged 75+ years were included.Outcome measuresWe examined associations between frailty and use of healthcare resources in hospital and in the municipality as well as the association between frailty and mortality.Results973 individuals aged 75+ years were included. Of these, 63.9% had a PRISMA-7 score ≥3 and were thus defined as frail. Frail individuals were older compared with non-frail with mean ages of 84.6 and 80.4 years, respectively, p>0.001. Age and gender-adjusted mortality after 1 year was higher among the frail (OR 2.46, 95% CI 1.53 to 3.97). Use of healthcare services in the municipality as well as hospital admissions was significantly higher among frail individuals.ConclusionsBased on these findings we consider PRISMA-7 to be useful in an in-hospital setting as a screening tool to identify frail elderly patients who may profit from further geriatric assessment during hospital stay.Trial registration numberID REG-070-2017.

Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID Symptom Study app: a prospective, community-based, nested, case-control study

“…For this analysis, the outcome variable was case status (a self-reported positive RT-PCR test or LFAT for SARS-CoV-2). We considered a priori-defined risk factors for SARS-CoV-2 infection based on previous evidence in unvaccinated individuals: 16 , 17 , 18 age; BMI; self-reported comorbidities (ie, cancer, diabetes, asthma, lung disease, heart disease, and kidney disease), analysed individually as binary variables; dependency level (frailty) assessed by the PRISMA-7 questionnaire, which is embedded in app registration, 24 , 25 as a binary variable (PRISMA-7 score ≥3 defined as frail and <3 defined as not frail); 26 local area Index of Multiple Deprivation (IMD; a score ranging from 1 [most deprived] to 10 [least deprived] estimating relative locality deprivation derived from postal code and lower layer super output area) divided into low IMD (1–3), intermediate IMD (4–7), and high IMD (8–10) groups; 27 and four healthy lifestyle factors (no current smoking, no obesity [BMI <30 kg/m 2 ], physical activity at least once per week [non-sedentary], and a healthy diet pattern; appendix p 17 ). We also calculated a healthy lifestyle score on the basis of these four lifestyle factors, 28 by which participants received 1 point for each healthy lifestyle factor and the sum of the scores gave a total healthy lifestyle score ranging from 0 to 4, with higher scores indicating a healthier lifestyle ( appendix p 17 ).…”

Post-vaccination SARS-CoV-2 infection: risk factors and illness profile in a prospective, observational community-based case-control study

“…For this analysis the outcome variable was case status (self-reported positive RT-PCR test or LFAT for SARS-CoV-2). We considered a-priori defined risk factors for SARS-CoV-2 infection based on previous evidence for unvaccinated individuals(15-17): age; BMI; self-reported comorbidities including cancer, diabetes, asthma, lung disease, heart disease, and kidney disease analysed individually as binary variables; dependency level (frailty), assessed by the PRISMA7 questionnaire (embedded in app registration) (23, 24), as a binary variable (PRISMA7 ≥ 3 = frail; PRISMA7 < 3 = not frail) (25); local area Index of Multiple Deprivation (IMD), a score, ranging from 1 (most deprived) to 10 (least deprived) estimating relative locality deprivation derived from postal code, divided into low IMD[1-3], middle IMD[4-7], and high IMD[8-10] groups (26); four healthy lifestyle factors including no current smoking, no obesity (Body Mass Index<30), physical activity at least once weekly, and a healthier diet pattern. We also considered a healthy lifestyle score based on these four healthy lifestyle factors (27) (see Supplementary Methods).…”

“…We assessed age, self-reported comorbidities (cancer, diabetes, asthma, lung disease, heart disease, and kidney disease) analysed individually as binary variables; dependency level (frailty), assessed by the PRISMA7 questionnaire (embedded in the app registration) (23,24) and classified as a binary variable (PRISMA7 ≥ 3 = frail; PRISMA7 < 3 = not frail) (25); local area Index of Multiple Deprivation (IMD), a score, ranging from 1 (most deprived) to 10 (least deprived) providing an estimate of relative locality deprivation derived from postal code on registration, divided into low (1-3), middle (4-7), and high (8-10) groups (26); and a healthy lifestyle score based on four lifestyle factors ( 27) -no current smoking, no obesity (Body Mass Index<30), physical activity at least once weekly, and a healthier diet pattern (see Supplementary Methods).…”

Exercise interventions for older people at risk for frailty

“…The main outcomes in this study are the scores of the following frailty indices referenced in the literature: Fried Frailty Phenotype Criteria [ 19 ] ; Frailty Trait Scale–short version [ 20 ] ; SHARE Frailty Instrument [ 21 ] ; the FRAIL scale [ 22 ] ; the Gérontopôle Frailty Screening Tool [ 31 ] ; the Clinical Frailty Scale [ 25 ] ; the Rockwood and Mitnitsky Frailty Index [ 22 ] ; the Edmonton Frailty Scale [ 23 ] ; the Fatigue, Resistance, Ambulation, Illness and Loss of weight Index [ 24 ] ; the Multidimensional Prognostic Index [ 26 ] ; the Tilburg Frailty Indicator [ 27 ] ; PRISMA-7 [ 28 ] ; the Groningen Frailty Indicator [ 29 ] ; the Sherbrooke Postal Questionnaire [ 30 ] ; and the Kihon Checklist. [ 32 ]…”