Assessing Frailty in Chinese Nursing Home Older Adults: A Comparison Between the FRAIL-NH Scale and Frailty Index
- 26 Downloads
To establish appropriate FRAIL-NH cutoff points in nursing homes in Mainland China;
To compare the FRAIL-NH scale and Frailty Index in assessing frailty prevalence and associated factors in nursing homes.
A cross-sectional study.
Six nursing homes in Changsha, China.
A total of 302 residents aged 60 years or older (mean aged 82.71±8.49, 71.2% female).
Frailty was assessed using the 34-item Frailty Index and the FRAIL-NH scale.
The appropriate FRAIL-NH cutoff points to classify frail status and frailest status were 1.5 (87.6% sensitivity, 63.3% specificity) and 7.5 (94.1% sensitivity, 73.4% specificity), respectively. Based on the FRAIL-NH and Frailty Index, 69.5% (48% for frail and 21.5% for frailest), and 66.5% (60.9% for frail and 5.6% for frailest) of residents were at risk of frailty, respectively. There was no statistically significant difference in the total frailty prevalence assessed by FRAIL-NH and Frailty Index (χ2=0.617, P=0.432). The FRAIL-NH Scale is significantly associated with the Frailty Index (correlation coefficient (r) = 0.74, P < 0.001), but there was a Kappa agreement of 0.39 for frailty classification between the FRAIL-NH and Frailty Index, with the Frailty Index classifying a larger number of individuals as frail. When using FRAIL-NH scale, disease and self-reported health status were associated with frail and frailest status while age was just associated with frailest status. regarding the Frailty Index, age, diseases, medications and self-reported health status were associated with frail and frailest status.
The FRAIL-NH is a simple and effective tool to assess the overall frailty rate in nursing homes, and the Frailty Index may be more suitable capturing the multidimensionality of frailty at an individual level. Careful consideration in the selection of a frailty instrument, based on the intended purpose, is necessary.
Key wordsChina FRAIL-NH Frailty Index nursing home older adults
- 3.Kojima G. Frailty as a predictor of nursing home placement among community-dwelling older adults: a systematic review and meta–analysis. J Geriatr Phys Ther 2016; 41:1–7.Google Scholar
- 5.Zhao Y–Y, ·Li XW, Ding YP, Cui Y. Comparison of predictive power for disability among institutional older adults using Tilburg scale and frality phenotype. Chinese J Heal Stat 2017; 34:436–438.Google Scholar
- 11.Martínez–Velilla N, Herce PA, Herrero ÁC, et al. Heterogeneity of different tools for detecting the prevalence of frailty in nursing homes: feasibility and meaning of different approaches. J Am Med Dir Assoc 2017; 18:898.e1–898.e8.Google Scholar
- 16.Wei Z–Z, Wang WL. The cutoff point of POSM–SF questionnaire to define preoperative negative mood disorders in patients undergoing gastric cancer radical surgery. Chinese J Nurs 2011; 46:169–171.Google Scholar
- 17.Searle SD, Mitnitski A, Gahbauer EA, Gill TM, Rockwood K. A standard procedure for creating a frailty index. Bmc Geriatr 2008; 24:1–10.Google Scholar
- 18.Hoover M, Rotermann M, Sanmartin C, Bernier J. Validation of an index to estimate the prevalence of frailty among community–dwelling seniors. Heal Reports 2013; 24:10–17.Google Scholar
- 19.Vetrano DL, Palmer K, Marengoni A, et al. Frailty and multimorbidity: a systematic review and meta–analysis. Journals Gerontol 2018(in press).Google Scholar
- 21.Malmstrom TK, Miller DK, Morley JE, Louis S, Louis S, Louis S. A comparison of four frailty models. 2015; 62:721–726.Google Scholar
- 27.Xi X, Guo GF, Sun J. Elderly frailty assessment tools and their applications. Chinese J Gerontol 2015; 35:5993–5996.Google Scholar