The Korean version of the FRAIL scale: clinical feasibility and validity of assessing the frailty status of Korean elderly

Abstract

Background/Aims:The fatigue, resistance, ambulation, illnesses, and loss of weight (FRAIL) scale is a screening tool for frailty status using a simple 5-item questionnaire. The aim of this study was to evaluate the clinical feasibility and validity of the Korean version of the FRAIL (K-FRAIL) scale.Methods:Questionnaire items were translated and administered to 103 patients aged ≥ 65 years who underwent a comprehensive geriatric assessment at the Seoul National University Bundang Hospital. In this cross-sectional study, the K-FRAIL scale was compared with the domains and the multidimensional frailty index of the comprehensive geriatric assessment. We also assessed the time required to complete the scale.Results:The participants’ mean age was 76.8 years (standard deviation [SD], 6.1), and 55 (53.4%) were males. The mean overall frailty index was 0.19 (SD, 0.17). For K-FRAIL-robust, prefrail, and frail patients, the mean frailty indices were 0.09, 0.18, and 0.34, respectively (p for trend < 0.001). A higher degree of impairment in the K-FRAIL scale was associated with worse nutritional status, poor physical performance, functional dependence, and polypharmacy. The number of items with impairment in the K-FRAIL scale was positively associated with the frailty index (B = 3.73, p < 0.001). The K-FRAIL scale could differentiate vulnerability from robustness with a sensitivity of 0.90 and a specificity of 0.33. Of all patients, 75 (72.8%) completed the K-FRAIL scale within < 3 minutes.Conclusions:The K-FRAIL scale is correlated with the frailty index and is a simple tool to screen for frailty in a clinical setting.

Korean version of the Fatigue, Resistance, Ambulation, Illnesses and Loss of weight questionnaire versus the Modified Kihon Checklist for Frailty Screening in Community‐Dwelling Older Adults: The Aging Study of PyeongChang Rural Area

“…On the other hand, the K-FRAIL questionnaire that consists of 5 items can be administered within 3 minutes, without a face-to-face visit. 12 This simple questionnaire has proven effective in screening for frailty in American, 13, 14 European, 27 and Asian populations. 12 Therefore, it can be a useful population screening tool to identify vulnerable older adults in the community.…”

“…12 This simple questionnaire has proven effective in screening for frailty in American, 13, 14 European, 27 and Asian populations. 12 Therefore, it can be a useful population screening tool to identify vulnerable older adults in the community. 5 Individuals who screen positive according to the K-FRAIL questionnaire can undergo a comprehensive geriatric assessment and receive resource-intensive, multi-disciplinary interventions.…”

“…12 It assigns 1 point to each of the following 5 components: 1) fatigue (response of “all of the time” or “most of the time” to the question “how much of the time during the past 4 weeks did you feel tired?”); 2) resistance (positive response to the question “by yourself and not using aids, do you have any difficulty walking up 10 steps without resting?”); 3) ambulation (positive response to the question “by yourself and not using aids, do you have any difficulty walking 300 meters?”); 4) illnesses (5 or more self-reported physician diagnoses of hypertension, diabetes, cancer excluding a minor skin cancer, chronic lung disease, heart attack, congestive heart failure, angina, asthma, arthritis, stroke, and kidney disease); 5) loss of weight (more than 5% in the past year). Individuals were classified as robust if the score is 0 or vulnerable if ≥1 (prefrail if 1–2 and frail if 3–5).…”

“…Individuals were classified as robust if the score is 0 or vulnerable if ≥1 (prefrail if 1–2 and frail if 3–5). 12,13 …”

Starting Construction of Frailty Cohort for Elderly and Intervention Study

“…To finalize the Korean version, we included previously validated Korean and international frailty assessment tools in the survey for this cohort study. These included the Cardiovascular Health Study Frailty Index 7) , the Korean Longitudinal Study on Health and Aging Frailty Index 8) , the Korean version of the Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight scale 9) , the Korean Frailty Index 10) , and the Frailty Instrument 11) . One aim of the project is the development of a 3-axis accelerometer-based wearable gait analysis system for frailty prevention.…”