Validation of the Korean Frailty Index in community-dwelling older adults in a nationwide Korean Frailty and Aging Cohort study

Abstract

Background/Aims: We aimed to assess validity of the Korean Frailty Index (KFI) and the modified KFI (mKFI) in nationwide Korean population as screening measures for frailty status in older adults. Methods: Analysis was performed in the records of baseline assessments of 2,886 participants in the Korean Frailty Aging Cohort study from 2016 to 2017. The KFI included eight items on a history of hospitalization, self-reported health status, polypharmacy, weight loss, mood, incontinence, sensory problems, and timed up and go test. In mKFI, timed up and go test was replaced with a question whether a person can walk around a schoolyard. Cardiovascular Health Study (CHS) frailty scale was used as a gold standard. Results: In study population (mean age, 76; 47.6% men), score of the KFI correlated with the CHS scale. The KFI correlated with common geriatric parameters including Activities of Daily Living, nutritional status, cognitive performance, and mood. As a construct validity, items of KFI correlated with CHS scale. As a criterion validity, sensitivity was 81.6%, specificity was 67.0% to predict frailty by CHS scale with the score of 3 or higher in KFI. The KFI and mKFI correlated with each other (R 2 = 0.88), and prediction ability for frailty by CHS scale was not significantly differed between KFI and mKFI. Conclusions: The KFI and mKFI are valid instruments for frailty screening and might be useful as simple frailty screening tools to identify older adults who might benefit from comprehensive geriatric assessment and integrated, multidisciplinary geriatric care services.

Health Literacy and Frailty in Community-Dwelling Older Adults: Evidence from a Nationwide Cohort Study in South Korea

“…Older Koreans have approximately 2.7 chronic diseases on average [37]. Approximately 47% and 8% are estimated to have prefrailty and frailty, respectively [26,28]. In light of this social context, there is an increasing need to identify preventive and risk factors of pre-frailty and frailty [7,8].…”

“…Frailty status was evaluated with the Korean frailty index (KFI), which was developed by a Korean Geriatrics Society research panel and previously validated among communitydwelling older adults [27,28]. The KFI consists of the following eight items: (a) a history of hospitalization in the past year (1 = yes), (b) self-rated health status (1 = poor), (c) weight loss in the past year to the extent that one's clothes fit loosely (1 = yes), (d) polypharmacy (1 = taking four or more medications regularly), (e) depressed mood (1 = experiencing sadness or depressed mood for sometimes or more frequently in the last month), (f) incontinence (1 = experiencing incontinence of urine or feces for sometimes or more frequently in the last month), (g) visual or auditory problems (1 = any problems with decreased visual acuity or difficulties with hearing in daily life), and (h) physical performance measured with the Times Up and Go Test (TUGT) (1 = taking more than 10 seconds).…”

Validity of the Clinical Frailty Scale in Korean older patients at a geriatric clinic

“…Despite numerous efforts to develop valid and feasible screening instruments for frailty, instruments have distinct drawbacks in clinical use. Screening questionnaires are usually validated in community-based studies rather than in acute or chronic care situations for older adults with complex care needs [ 14 ], and they might not be suitable to capture the diverse spectrum of disabilities and comorbidities. For instance, the question about loss of body weight to screen the risk of malnutrition can be only effective if the person is in the course of losing weight, and it might not be able to capture an advanced frailty status with already decreased lean mass.…”

“…In acute care settings, performing comprehensive geriatric assessments (CGAs) for older patients is less feasible as CGAs frequently take > 30 minutes for a single patient. To address this unmet need, several screening measures of frailty for older adults have been developed and validated [11][12][13][14]. Among these instruments, the ones requiring physical performance assessments might be less applicable for acute hospital settings where patients experience sudden deconditioning due to acute illnesses.…”

Frailty index and gender‐specific mortality in Korean adults: Findings from the Korean Longitudinal Study of Aging (2006–2018)

“…It is a useful tool to describe the trajectories of individuals' health status over time (Cesari et al, 2014). The index has been widely used to measure biological age in both western and eastern countries (Fan et al, 2020; Hoogendijk et al, 2020; Jung et al, 2021; Shi et al, 2021). Research shows that community‐dwelling adults are prone to developing frailty (Ofori‐Asenso et al, 2019).…”