Use of the Frailty Index and FRAIL-NH Scale for the Assessment of the Frailty Status of Elderly Individuals Admitted in a Long-term Care Hospital in Korea

Ga, Hyuk; Won, Chang Won

doi:10.4235/agmr.2018.22.1.20

Cited by 16 publications

(22 citation statements)

References 18 publications

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“…In outcome prediction modelling, we used combined institutionalization due to functional decline and mortality as a major study outcome, because mortality alone was insufficient to produce statistically meaningful differences in analysis. However, as a study showing that chronic institutionalization occurs in older adults who are functionally dependent, and rather irreversible, resulting in death in initially admitted facilities, institutionalization might be considered as a major outcome of mortality. Also, the cohort study was based in a single rural region of Korea; therefore, generalization in the global population may be restricted.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of sarcopenia by European consensuses and a phenotype score

Jang

Lee

et al. 2019

J cachexia sarcopenia muscle

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Background We aimed to assess the clinical characteristics of sarcopenia by the original and revised European Working Group on Sarcopenia in Older People (EWGSOP 1 and 2), and to propose a new sarcopenia phenotype score (SPS) to improve relevance of clinical outcomes. Methods Analyses were performed in 1408 older adults of the Aging Study of PyeongChang Rural Area, a community-based cohort in Korea. For sarcopenia definitions, we used EWGSOP 1, EWGSOP 2, and SPS, a new index counting number of abnormal domains among components of grip strength, gait speed, or muscle mass. Frailty status by the frailty index and the Cardiovascular Health Study frailty score was compared with sarcopenia measures. Prediction ability for composite outcome combining death and institutionalization due to functional decline was assessed among sarcopenia measures. Results Generally, sarcopenia spectrum by both EWGSOP 1 and 2 was associated with worse functional status in parameters of geriatric assessments. However, population who were considered as sarcopenic by EWGSOP 1, but not by EWGSOP 2, showed increased risk of composite outcome and worse frailty status, compared with people who were classified as not sarcopenic by both EWGSOP 1 and 2. With SPS, dose-response relationship was observed with both frailty status and outcome prediction. Prediction for composite outcome was better in SPS than in EWGSOP 2 classification. Conclusions A new SPS might be used to classify sarcopenic burden in older adults to resolve possible inconsistencies in phenotype correlation and outcome prediction of EWGSOP 2 criteria.

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Section: Discussionmentioning

confidence: 99%

Characteristics of sarcopenia by European consensuses and a phenotype score

Jang

Lee

et al. 2019

J cachexia sarcopenia muscle

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“…FRAIL-NH score of 0–1 is robust, 2–6 pre-frail and 7 or above as frail [ 22 ]. The FRAIL-NH scale has been validated in Asians populations including Korea [ 23 ]. Locally, FRAIL has been compared to other frailty measurements such as the Clinical Frailty Scale and Tilburg Frailty Indicator, and has been found to be better at predicting in-hospital mortality and length of hospitalisation [ 24 ].…”

Section: Methodsmentioning

confidence: 99%

Healthcare utilisation in the last year of life in internal medicine, young-old versus old-old

Chen

et al. 2020

BMC Geriatr

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Background With increasing cost of healthcare in our aging society, a consistent pain point is that of end-of-life care. It is particularly difficult to prognosticate in non-cancer patients, leading to more healthcare utilisation without improving quality of life. Additionally, older adults do not age homogenously. Hence, we seek to characterise healthcare utilisation in young-old and old-old at the end-of-life. Methods We conducted a single-site retrospective review of decedents under department of Advanced Internal Medicine (AIM) over a year. Young-old is defined as 65–79 years; old-old as 80 years and above. Data collected was demographic characteristics; clinical data including Charlson Comorbidity Index (CCI), FRAIL-NH and advance care planning (ACP); healthcare utilisation including days spent in hospital, hospital admissions, length of stay of terminal admission and clinic visits; and quality of end-of-life care including investigations and symptomatic control. Documentation was individually reviewed for quality of communication. Results One hundred eighty-nine older adult decedents. Old-old decedents were mostly females (63% vs. 42%, p = 0.004), higher CCI scores (7.7 vs 6.6, p = 0.007), similarly frail with lower polypharmacy (62.9% vs 71.9%, p = 0.01). ACP uptake was low in both, old-old 15.9% vs. young-old 17.5%. Poor prognosis was conveyed to family, though conversation did not result in moderating extent of care. Old-old had less healthcare utilisation. Adjusting for sex, multimorbidity and frailty, old-old decedents had 7.3 ± 3.5 less hospital days in their final year. Further adjusting for cognition and residence, old-old had 0.5 ± 0.3 less hospital admissions. When accounted for home care services, old-old spent 2.7 ± 0.8 less hospital days in their last admission. Conclusion There was high healthcare utilisation in older adults, but especially young-old. Enhanced education and goal-setting are needed in the acute care setting. ACP needs to be reinforced in acute care with further research to evaluate if it reduces unnecessary utilisation at end-of-life.

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“…Another explanation may be the high prevalence of frailty among LTCH patients who are more physically vulnerable compared to those in other nursing homes. 17 )…”

Section: Discussionmentioning

confidence: 99%

“…Another explanation may be the high prevalence of frailty among LTCH patients who are more physically vulnerable compared to those in other nursing homes. 17) Rothan-Tondeur et al 16) reported bronchitis (35.5%) to be the most common type of HAI, followed by gastroenteritis (23.8%), UTI (16.7%), otorhinolaryngological infection (8.7%), and pneu- Values are presented as number (%) or mean±standard deviation. monia (7.0%).…”

Section: B)mentioning

confidence: 99%