Validation and Screening Capacity of the European Portuguese Version of the SUNFRAIL Tool for Community-Dwelling Older Adults

Abstract

Early detection of frailty may prevent or delay adverse health outcomes in community-dwelling older adults. In Portugal, there are currently no valid multidimensional frailty screening tools. SUNFRAIL is a user-friendly multidimensional tool for frailty screening that can be used in primary care. Aims: (i) to determine the validity and reliability of the European Portuguese version of the SUNFRAIL tool for use in community-dwelling older adults; (ii) to assess the screening capacity of this version of SUNFRAIL using Fried’s phenotypic model criteria for frailty as a reference test. Methods: Cross-sectional pilot study in a convenience sample of 128 community-dwelling older adults. Objective and subjective data were collected. Internal consistency, concurrent validity, sensitivity, and specificity (ROC curve analysis) were examined. Results: Internal consistency was low. Significant moderate to strong correlations were found between different domains and the total score. The differences between robust, pre-frail, and frail older adults were significant. SUNFRAIL was also correlated with multimorbidity. Sensitivity and specificity were satisfactory. Conclusions: The European Portuguese version of the SUNFRAIL tool is a promising frailty screening tool for community-dwelling older adults to be routinely used in clinical practice. However, more consistent results on its validity and reliability are needed to be used nationwide.

Role and Characteristics of Personal Care Assistants of Frail Older People with Functional Limitations Ageing in Place in Italy

“…The study has some limitations to be considered. The definition of frailty is based only on people aged 65 and over, living alone without cohabiting family and presenting functional limitations, thus needing support, as supported by some literature (e.g., [ 1 , 10 ]). A cognitive assessment of participants was based only on the information provided by the recruitment channels, in addition to those from respective relatives.…”

“…The worldwide population is often ageing in place, meaning at home. Such a context becomes crucial for frail older people, especially when they live alone and have limited physical/functional limitations [ 1 , 2 ]. Regarding the articulated issue of frailty, the absence of a gold standard for its identification emerges [ 3 , 4 , 5 ].…”

“…Regarding the articulated issue of frailty, the absence of a gold standard for its identification emerges [ 3 , 4 , 5 ]. According to the World Health Organisation (WHO) frailty is defined as “extreme vulnerability to endogenous and exogenous stressors that exposes an individual to a higher risk of negative health related outcomes” [ 6 ] (p. 227), which affect “several domains of human functioning (physical, psychological, and social)” [ 1 ] (p. 2). Moreover, the Italian Ministry of Health [ 7 ] highlights the need to detect frail people in order to provide tailored interventions for preventing disability.…”

“…Moreover, the Italian Ministry of Health [ 7 ] highlights the need to detect frail people in order to provide tailored interventions for preventing disability. This holistic approach, although comprehensive, is nevertheless complex to manage [ 8 , 9 ], and indeed “most of the available frailty screening tools do not address all domains of functioning” [ 1 ] (p. 2). In light of these considerations, our study adheres to a more accessible analysis of frailty, referring to a condition linked to ageing [ 1 ], and to living alone with limited functional abilities, due to a decline in “multiple physiological systems” [ 10 ].…”

“…This holistic approach, although comprehensive, is nevertheless complex to manage [ 8 , 9 ], and indeed “most of the available frailty screening tools do not address all domains of functioning” [ 1 ] (p. 2). In light of these considerations, our study adheres to a more accessible analysis of frailty, referring to a condition linked to ageing [ 1 ], and to living alone with limited functional abilities, due to a decline in “multiple physiological systems” [ 10 ]. This implies restrictions on independent living and the need for support [ 11 ], with existing social welfare provisions for older people becoming crucial [ 12 ].…”