Cargando…

Diagnostic accuracy of the FRAIL scale plus functional measures for frailty screening: a cross-sectional study

BACKGROUND: There is little knowledge of the diagnostic accuracy of screening programmes for frailty in primary care settings. AIM: To assess a two-step strategy consisting of the administration of the FRAIL scale to those who are non-dependent and aged ≥75 years, followed-up by measurement of the S...

Descripción completa

Detalles Bibliográficos
Autores principales: Rodríguez-Laso, Ángel, Martín-Lesende, Iñaki, Sinclair, Alan, Sourdet, Sandrine, Tosato, Matteo, Rodríguez-Mañas, Leocadio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Royal College of General Practitioners 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9680763/
http://dx.doi.org/10.3399/BJGPO.2021.0220
_version_ 1784834483469418496
author Rodríguez-Laso, Ángel
Martín-Lesende, Iñaki
Sinclair, Alan
Sourdet, Sandrine
Tosato, Matteo
Rodríguez-Mañas, Leocadio
author_facet Rodríguez-Laso, Ángel
Martín-Lesende, Iñaki
Sinclair, Alan
Sourdet, Sandrine
Tosato, Matteo
Rodríguez-Mañas, Leocadio
author_sort Rodríguez-Laso, Ángel
collection PubMed
description BACKGROUND: There is little knowledge of the diagnostic accuracy of screening programmes for frailty in primary care settings. AIM: To assess a two-step strategy consisting of the administration of the FRAIL scale to those who are non-dependent and aged ≥75 years, followed-up by measurement of the Short Physical Performance Battery (SPPB) or gait speed in those who are positive. DESIGN & SETTING: Cross-sectional and longitudinal cohort study. Analysis of primary care data from the FRAILTOOLS project at five European cities. METHOD: All primary care patients consecutively attending were enrolled. They received the index tests, plus the Fried frailty phenotype (FP) and the frailty index to assess their frailty status. Mortality and worsening of dependency in basic and instrumental activities of daily living (BADL and IADL) over 1 year were ascertained. RESULTS: Prevalence of frailty based on FP was 14.9% in the 362 participants. A FRAIL scale score ≥1 had a sensitivity of 83.3% (95% confidence interval [CI] = 73.1 to 93.6) to detect frailty. A positive result and an SPPB score <11 had a sensitivity of 72.2% (95% CI = 59.9 to 84.6); when combined with a gait speed <1.1 m/s, the sensitivity was 80.0% (95% CI = 68.5 to 91.5). Two-thirds of those screened as positive were not frail. In the best scenario, sensitivities of this last combination to detect IADL and BADL worsening were 69.4% (95% CI = 59.4 to 79.4) and 63.6% (95% CI = 53.4 to 73.9), respectively. CONCLUSION: Combining the FRAIL scale with other functional measures offers an acceptable screening approach for frailty. Accurate prediction of worsening dependency and death need to be confirmed through the piloting of a frailty screening programme.
format Online
Article
Text
id pubmed-9680763
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Royal College of General Practitioners
record_format MEDLINE/PubMed
spelling pubmed-96807632022-11-23 Diagnostic accuracy of the FRAIL scale plus functional measures for frailty screening: a cross-sectional study Rodríguez-Laso, Ángel Martín-Lesende, Iñaki Sinclair, Alan Sourdet, Sandrine Tosato, Matteo Rodríguez-Mañas, Leocadio BJGP Open Research BACKGROUND: There is little knowledge of the diagnostic accuracy of screening programmes for frailty in primary care settings. AIM: To assess a two-step strategy consisting of the administration of the FRAIL scale to those who are non-dependent and aged ≥75 years, followed-up by measurement of the Short Physical Performance Battery (SPPB) or gait speed in those who are positive. DESIGN & SETTING: Cross-sectional and longitudinal cohort study. Analysis of primary care data from the FRAILTOOLS project at five European cities. METHOD: All primary care patients consecutively attending were enrolled. They received the index tests, plus the Fried frailty phenotype (FP) and the frailty index to assess their frailty status. Mortality and worsening of dependency in basic and instrumental activities of daily living (BADL and IADL) over 1 year were ascertained. RESULTS: Prevalence of frailty based on FP was 14.9% in the 362 participants. A FRAIL scale score ≥1 had a sensitivity of 83.3% (95% confidence interval [CI] = 73.1 to 93.6) to detect frailty. A positive result and an SPPB score <11 had a sensitivity of 72.2% (95% CI = 59.9 to 84.6); when combined with a gait speed <1.1 m/s, the sensitivity was 80.0% (95% CI = 68.5 to 91.5). Two-thirds of those screened as positive were not frail. In the best scenario, sensitivities of this last combination to detect IADL and BADL worsening were 69.4% (95% CI = 59.4 to 79.4) and 63.6% (95% CI = 53.4 to 73.9), respectively. CONCLUSION: Combining the FRAIL scale with other functional measures offers an acceptable screening approach for frailty. Accurate prediction of worsening dependency and death need to be confirmed through the piloting of a frailty screening programme. Royal College of General Practitioners 2022-08-24 /pmc/articles/PMC9680763/ http://dx.doi.org/10.3399/BJGPO.2021.0220 Text en Copyright © 2022, The Authors https://creativecommons.org/licenses/by/4.0/This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)
spellingShingle Research
Rodríguez-Laso, Ángel
Martín-Lesende, Iñaki
Sinclair, Alan
Sourdet, Sandrine
Tosato, Matteo
Rodríguez-Mañas, Leocadio
Diagnostic accuracy of the FRAIL scale plus functional measures for frailty screening: a cross-sectional study
title Diagnostic accuracy of the FRAIL scale plus functional measures for frailty screening: a cross-sectional study
title_full Diagnostic accuracy of the FRAIL scale plus functional measures for frailty screening: a cross-sectional study
title_fullStr Diagnostic accuracy of the FRAIL scale plus functional measures for frailty screening: a cross-sectional study
title_full_unstemmed Diagnostic accuracy of the FRAIL scale plus functional measures for frailty screening: a cross-sectional study
title_short Diagnostic accuracy of the FRAIL scale plus functional measures for frailty screening: a cross-sectional study
title_sort diagnostic accuracy of the frail scale plus functional measures for frailty screening: a cross-sectional study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9680763/
http://dx.doi.org/10.3399/BJGPO.2021.0220
work_keys_str_mv AT rodriguezlasoangel diagnosticaccuracyofthefrailscaleplusfunctionalmeasuresforfrailtyscreeningacrosssectionalstudy
AT martinlesendeinaki diagnosticaccuracyofthefrailscaleplusfunctionalmeasuresforfrailtyscreeningacrosssectionalstudy
AT sinclairalan diagnosticaccuracyofthefrailscaleplusfunctionalmeasuresforfrailtyscreeningacrosssectionalstudy
AT sourdetsandrine diagnosticaccuracyofthefrailscaleplusfunctionalmeasuresforfrailtyscreeningacrosssectionalstudy
AT tosatomatteo diagnosticaccuracyofthefrailscaleplusfunctionalmeasuresforfrailtyscreeningacrosssectionalstudy
AT rodriguezmanasleocadio diagnosticaccuracyofthefrailscaleplusfunctionalmeasuresforfrailtyscreeningacrosssectionalstudy