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BMC Geriatr. 2017 Nov 13;17(1):264. doi: 10.1186/s12877-017-0623-0.

Measuring frailty in clinical practice: a comparison of physical frailty assessment methods in a geriatric out-patient clinic.

Author information

1
Geriatric Education and Research for the Aging Sciences (GERAS), St Peter's Hospital, 88 Maplewood Ave, Hamilton, ON, L8M 1W9, Canada. pritcjm@mcmaster.ca.
2
Department of Kinesiology and Interdisciplinary Science, McMaster University, 1280 Main St West, Hamilton, ON, L8S 4L8, Canada. pritcjm@mcmaster.ca.
3
Geriatric Education and Research for the Aging Sciences (GERAS), St Peter's Hospital, 88 Maplewood Ave, Hamilton, ON, L8M 1W9, Canada.
4
Department of Medicine, McMaster University, 1280 Main St West, Hamilton, ON, L8S 4L8, Canada.
5
Population Health Research Institute (PHRI), St. Joseph's Healthcare, Hamilton, ON, L8N 4A6, Canada.
6
Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main St West, Hamilton, ON, L8S 4L8, Canada.

Abstract

BACKGROUND:

The objectives of this study were to determine: 1) the prevalence of frailty using Fried's phenotype method and the Short Performance Physical Battery (SPPB), 2) agreement between frailty assessment methods, 3) the feasibility of assessing frailty using Fried's phenotype method and the SPPB.

METHODS:

This cross-sectional study was conducted at a geriatric out-patient clinic in Hamilton, Canada. A research assistant conducted all frailty assessments. Patients were classified as non-frail, pre-frail or frail according to Fried's phenotype method and the SPPB. Agreement among methods is reported using the Cohen kappa statistic (standard error). Feasibility data included the percent of eligible participants agreeing to attempt the frailty assessments (criterion for feasibility: ≥90% of patients agreeing to the frailty assessment), equipment required, and safety considerations. A p-value of <0.05 is considered significant.

RESULTS:

A total of 110 participants (92%) and 109 participants (91%) agreed to attempt Fried's phenotype method and SPPB, respectively. No adverse events occurred during any assessments. According to Fried's phenotype method, the prevalence of frailty and pre-frailty was 35% and 56%, respectively, and according to the SPPB, the prevalence of frailty and pre-frailty was 50% and 35%, respectively. There was fair to moderate agreement between methods for determining which participants were frail (0.488 [0.082], p < 0.001) and pre-frail (0.272 [0.084], p = 0.002).

CONCLUSIONS:

Frailty and pre-frailty are common in this geriatric outpatient population, and there is fair to moderate agreement between Fried's phenotype method and the SPPB. Over 90% of the patients who were eligible for the study agreed to attempt the frailty assessments, demonstrating that according to our feasibility criteria, frailty can be assessed in this patient population. Assessing frailty may help clinicians identify high-risk patients and tailor interventions based on baseline frailty characteristics.

KEYWORDS:

Frailty; Fried; Geriatric medicine; Out-patient; Phenotype; Short performance physical battery (SPPB)

PMID:
29132301
PMCID:
PMC5683585
DOI:
10.1186/s12877-017-0623-0
[Indexed for MEDLINE]
Free PMC Article

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