Feasibility and Factor Structure of the FRAIL Scale in Older Adults

Aprahamian, Ivan; Lin, Sumika Mori; Suemoto, Cláudia Kimie; Apolinário, Daniel; Cezar, Natália Oiring de Castro; Elmadjian, Serpui Marie; Yassuda, Mônica Sanches

doi:10.1016/j.jamda.2016.12.067

Cited by 55 publications

(53 citation statements)

References 29 publications

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“…In multiple regression analyses, hypertension was associated with a 1.59 risk for frailty, in agreement with the present findings. However, in our study, we used an easy and common way to identify frailty, which is recommended by international societies . The FRAIL scale is more suitable for use in clinical practice, especially in nonspecialized settings.…”

Section: Discussionmentioning

confidence: 99%

“…However, in our study, we used an easy and common way to identify frailty, which is recommended by international societies. [21][22][23] The FRAIL scale is more suitable for use in clinical practice, especially in nonspecialized settings.…”

Section: Discussionmentioning

confidence: 99%

“…The evaluation of activities of daily living was performed with the Functional Activities Questionnaire (FAQ) . Frailty was evaluated using the FRAIL‐BR scale …”

Section: Methodsmentioning

confidence: 99%

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Hypertension and frailty in older adults

Aprahamian

Sassaki

Santos

et al. 2017

J of Clinical Hypertension

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The association between hypertension and frailty syndrome in older adults remains unclear. There is scarce information about the prevalence of hypertension among frail elderly patients or on its relationship with frailty. Up to one quarter of frail elderly patients present without comorbidity or disability, yet frailty is a leading cause of death. The knowledge and better control of frailty risk factors could influence prognosis. The present study evaluated: (1) the prevalence of hypertension in robust, prefrail, and frail elderly; and (2) factors that might be associated with frailty including hypertension. A cross-sectional study was conducted in 619 older adults at a universitybased outpatient center. Study protocol included sociodemographic data, measures of blood pressure and body mass index, frailty screening according to the internationally validated FRAIL (fatigue, resistance, ambulation, illnesses, and loss of weight) scale, number of comorbidities, drug use assessment, physical activity, cognitive status, and activities of daily living. Ordinal logistic regression was used to evaluate factors associated with frailty. Prevalence of hypertension and frailty was 67.3% and 14.8%, respectively, in the total sample. Hypertension was more prevalent in the prefrail (72.5%) and frail (83%) groups than among controls (51.7%). Hypertension, physical activity, number of prescribed drugs, and cognitive performance were significantly associated with frailty status. Hypertension presented an odds ratio of 1.77 towards frailty (95% confidence interval, 1.21-2.60; P = .002). Hypertension was more prevalent in frail elderly patients and was significantly associated with frailty. Intensive control of hypertension could influence the trajectory of frailty, and this hypothesis should be explored in future prospective clinical trials.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Hypertension and frailty in older adults

Aprahamian

Sassaki

Santos

et al. 2017

J of Clinical Hypertension

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“…3.53 95% CI 1.66, 7.49 P.001; pooled HR 1.75 95% CI 1.14, 2.70 P.01, respectively) [90]. Aprahamian et al found that in work with the Brazilian adoption of the FRAIL Scale that physical performance (ambulation and resistance) items on the scale were strongly associated with higher age and dementia, whereas health status (fatigue, weight loss, and illnesses) were more associated with female gender and depression, suggesting two subdimensions of the scale and different pathways to frailty [91]. Dong et al used a Chinese version of the FRAIL scale in 1235 older Chinese adults.…”

Section: Predictive Validity Of 3 Items From Screen II and Screen Ii Abmentioning

confidence: 99%

Screening Community-Living Older Adults for Protein Energy Malnutrition and Frailty: Update and Next Steps

et al. 2019

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Protein-energy malnutrition (PEM)/undernutrition and frailty are prevalent, overlapping conditions impacting on functional and health outcomes of older adults, but are frequently unidentified and untreated in community settings in the United States. Using the World Health Organization criteria for effective screening programs, we reviewed validity, reliability, and feasibility of data-driven screening tools for identifying PEM and frailty risk among community-dwelling older adults. The SCREEN II is recommended for PEM screening and the FRAIL scale is recommended as the most promising frailty screening tool, based on test characteristics, cost, and ease of use, but more research on both tools is needed, particularly on predictive validity of favorable outcomes after nutritional/physical activity interventions. The Malnutrition Screening Tool (MST) has been recommended by one expert group as a screening tool for all adults, regardless of age/care setting. However, it has not been tested in US community settings, likely yields large numbers of false positives (particularly in community settings), and its predictive validity of favorable outcomes after nutritional interventions is unknown. Community subgroups at highest priority for screening are those at increased risk due to prior illness, certain demographics and/or domiciliary characteristics, and those with BMI < 20 kg/m 2 or < 22 if > 70 years or recent unintentional weight loss > 10% (who are likely already malnourished). Community-based health professionals can better support healthy aging by increasing their awareness/use of PEM and frailty screening tools, prioritizing high-risk populations for systematic screening, following screening with more definitive diagnoses and appropriate interventions, and re-evaluating and revising screening protocols and measures as more data become available.

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“…A possible association between medication harm, polypharmacy and frailty has been suggested (25,26). Polypharmacy presented high prevalence in most cross-sectional and longitudinal studies, and it was associated with incident frailty (27)(28)(29)(30)(31). The association between frailty and polypharmacy is not related to the number of medications involved (27) and presents more negative outcomes among those cognitively impaired or defined as cognitively frail (30,32).…”

mentioning

confidence: 99%