Heterogeneity of Different Tools for Detecting the Prevalence of Frailty in Nursing Homes: Feasibility and Meaning of Different Approaches

Martínez‐Velilla, Nicolás; Herce, Pablo Aldaz; Herrero, Alvaro Casas; Gutiérrez-Valencia, Marta; Asteasu, Mikel L. Sáez de; Mateos, Alberto Sola; Zubillaga, Ana Conde; Ibáñez, Berta; Galbete, Arkaitz; Izquierdo, Mikel

doi:10.1016/j.jamda.2017.06.016

Cited by 28 publications

(37 citation statements)

References 22 publications

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“…The first difficulty encountered when analysing the ensemble of selected studies was the lack of homogeneity in the definition and quantification of frailty. The different scales used and their underlying concepts lead to a wide variability in the calculation of prevalence and incidence of frailty, prefrailty and of all outcomes associated with these syndromes . Additionally, different study settings, age ranges and pathologies of the participants, or differences in inclusion or exclusion criteria may influence the results and conclusions of every study.…”

Section: Discussionmentioning

confidence: 99%

The relationship between frailty and polypharmacy in older people: A systematic review

Gutiérrez-Valencia

Izquierdo

Cesari

et al. 2018

Brit J Clinical Pharma

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314

219

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Section: Discussionmentioning

confidence: 99%

The relationship between frailty and polypharmacy in older people: A systematic review

Gutiérrez-Valencia

Izquierdo

Cesari

et al. 2018

Brit J Clinical Pharma

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314

219

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“…Está validada para detectar fragilidad en el ámbito de AP y tiene una elevada fiabilidad en predecir discapacidad. Una puntuación de 10-12 se consideró no frágil, de 4-9 frágil, y entre 0 y 3 discapacitado 18 22 . La identificación de pacientes frágiles facilita la posible intervención y selección de aquellos que pueden beneficiarse de medidas preventivas o terapéuticas, ya que las situaciones de discapacidad ya establecidas son más complejas de revertir.…”

Section: Materials Y Métodosunclassified

Heterogeneity amongst different diagnostic tools in frailty screening

Redín-Sagredo

Herce

Herrero

et al. 2019

An Sist Sanit Navar

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“…Frailty Index (FI) and PPF are well-recognized and commonly used frailty assessment tools in nursing home settings [4]; however, they are not always feasible in routine practice in Chinese nursing homes because they are complex and time-consuming to use and are difficult to operate [5–8]. Other frailty assessment tools (e.g., TFI [9], Clinical Frailty Scale [10]) were mainly developed for community-dwellers and inpatients and were inappropriate for nursing home residents.…”

Section: Introductionmentioning

confidence: 99%

“…FRAIL-NH is a short, easy-to-administer and valid frailty assessment tool with high predictive ability of adverse outcomes [6, 11, 13]. It has been validated in many countries around the world, including the U.S. [11], France [6], Spain [8], Australia [7] and Hong Kong in China [13]. However, to the best of our knowledge, it has not been validated in mainland China.…”

Section: Introductionmentioning

confidence: 99%

“…ROC curve analysis is a valid method to estimate the discriminatory ability of screening tools and to determine their best cutoff points that can directly aid diagnostic decisions [14]. Different FRAIL-NH cutoff points have been established in countries such as Australia and Spain [7, 8, 11, 13]; however, these cutoff points might be inappropriate for nursing home older adults in mainland China because the cutoff points vary in different cultures and ethnicities [15]. Determining the appropriate FRAIL-NH cutoff points offers a simple and accurate way to identify older people who are at risk of frailty and provide timely intervention.…”

Section: Introductionmentioning

confidence: 99%

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Accessing the discriminatory performance of FRAIL-NH in two-class and three-class frailty and examining its agreement with the frailty index among nursing home residents in mainland China

Gao

Liu

et al. 2019

BMC Geriatr

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BackgroundFRAIL-NH has been commonly used to assess frailty in nursing home residents and validated in many ethnic populations; however, it has not been validated in mainland China, where such an assessment tool is lacking. This study aimed to (1) assess the discriminatory performance of FRAIL-NH in two-class frailty (non-frail+ pre-frail vs. frail) and three-class frailty (non-frail vs. pre-frail vs. frail), based on the Frailty Index (FI), (2) determine the appropriate cutoff points for FRAIL-NH that distinguish two-class and three-class frailty, and (3) examine the agreement in classification between FRAIL-NH and FI.MethodsA cross-sectional study of 302 residents aged 60 years or older from six nursing homes in Changsha was conducted. The FRAIL-NH scale and 34-item FI were used to measure frailty. Two-way and three-way receiver operating characteristic (ROC) curves were used to estimate the performance of FRAIL-NH. Cohen’s Kappa statistics were used to examine the agreement between these two measures.ResultsThe agreement between FRAIL-NH and FI ranged from 0.33 to 0.55. Regardless of what FI cutoff points were based on, the volume under the ROC surface (VUS) for FRAIL-NH from the three-way ROC were higher than the VUS of a useless test (1/6), and the area under the ROC curve (AUC) for FRAIL-NH from the two-way ROC were higher than the clinically meaningless value (0.5). When using FI cutoff points of 0.20 for pre-frail and 0.45 for frail, FRAIL-NH cutoff points of 1 and 9 in classifying three-class frailty had the highest VUS and the largest correct classification rates. Whichever FI was chosen, the performance of FRAIL-NH in distinguishing between pre-frailty and frailty, and between non-frailty and pre-frailty was equivalent. According to FRAIL-NH, the proportion of individuals with frailty misclassified as pre-frailty was higher than that of individuals with non-frailty misclassified as pre-frailty.ConclusionFRAIL-NH can be used as a preliminary frailty screening tool in nursing homes in mainland China. FI should be further used especially for those classified as pre-frailty by FRAIL-NH. It is not advisable to simply combine adjacent two classes of FRAIL-NH to create a new frailty variable in research settings.

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Heterogeneity of Different Tools for Detecting the Prevalence of Frailty in Nursing Homes: Feasibility and Meaning of Different Approaches

Cited by 28 publications

References 22 publications

The relationship between frailty and polypharmacy in older people: A systematic review

The relationship between frailty and polypharmacy in older people: A systematic review

Heterogeneity amongst different diagnostic tools in frailty screening

Accessing the discriminatory performance of FRAIL-NH in two-class and three-class frailty and examining its agreement with the frailty index among nursing home residents in mainland China

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