The predictive validity of three self-report screening instruments for identifying frail older people in the community

Abstract

BackgroundIf brief and easy to use self report screening tools are available to identify frail elderly, this may avoid costs and unnecessary assessment of healthy people. This study investigates the predictive validity of three self-report instruments for identifying community-dwelling frail elderly.MethodsThis is a prospective study with 1-year follow-up among community-dwelling elderly aged 70 or older (n = 430) to test sensitivity, specificity, and positive and negative predicted values of the Groningen Frailty Indicator, Tilburg Frailty Indicator and Sherbrooke Postal Questionnaire on development of disabilities, hospital admission and mortality. Odds ratios were calculated to compare frail versus non-frail groups for their risk for the adverse outcomes.ResultsAdjusted odds ratios show that those identified as frail have more than twice the risk (GFI, 2.62; TFI, 2.00; SPQ, 2,49) for developing disabilities compared to the non-frail group; those identified as frail by the TFI and SPQ have more than twice the risk of being admitted to a hospital. Sensitivity and specificity for development of disabilities are 71% and 63% (GFI), 62% and 71% (TFI) and 83% and 48% (SPQ). Regarding mortality, sensitivity for all tools are about 70% and specificity between 41% and 61%. For hospital admission, SPQ scores the highest for sensitivity (76%).ConclusionAll three instruments do have potential to identify older persons at risk, but their predictive power is not sufficient yet. Further research on these and other instruments is needed to improve targeting frail elderly.

Development of an instrument for the identification of frail older people as a target population for integrated care

“…19 Several short instruments were suggested for use as the first step. 20,27 These short instruments had characteristics that make them less suitable for the purpose of this study. First, most instruments are developed in the research realm and not tested in a primary care setting.…”

“…33 Self-assessment instruments have the lowest response rate in the most vulnerable group of patients, and the reliability of the information from frail patients, especially in case of cognitive problems, is questionable. 27 Therefore, this study developed its own first step, specifically developed for use in primary care.…”

An Evaluation of the Central Nervous System Medication Use and Frailty among Residents of Aged Care Homes in Malaysia

“…Frailty was measured using the GFI, developed by Steverink et al [29], and validated in institutionalized elderly [29,30,31,32,33,34,35,36,37,38,39]. The GFI contains 15 dichotomous items; with a total score range from 0 (normal activity without restriction) to 15 (completely disabled).…”

A disability prevention programme for community-dwelling frail older persons

“…41,42 In our feasibility study 13 among 41 elderly persons, nearly all participating elderly were willing to return the Groningen Frailty Indicator by post (90% response), and the number of missing items was low. The study into predictive values of three postal screening instruments 15 showed that all three instruments, including the Groningen Frailty Indicator, do have potential to identify older persons at risk, but their predictive power is not yet sufficient. A substantial proportion of elderly identified as frail by the Groningen Frailty Indicator did not develop adverse outcomes at one-year follow-up.…”