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Assessing Frailty in Chinese Nursing Home Older Adults: A Comparison between the Frail-NH Scale and Frailty Index

  • Published:
The journal of nutrition, health & aging

Abstract

Objective

  1. (1)

    To establish appropriate FRAIL-NH cutoff points in nursing homes in Mainland China;

  2. (2)

    To compare the FRAIL-NH scale and Frailty Index in assessing frailty prevalence and associated factors in nursing homes.

Design

A cross-sectional study.

Setting

Six nursing homes in Changsha, China.

Participants

A total of 302 residents aged 60 years or older (mean aged 82.71±8.49, 71.2% female).

Measurements

Frailty was assessed using the 34-item Frailty Index and the FRAIL-NH scale.

Results

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.

Conclusion

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.

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Author information

Authors and Affiliations

  1. Central South University Xiangya Nursing School, Changsha, Hunan, China

    F. Ge, Minhui Liu, Siyuan Tang & Y. Lu

  2. Johns Hopkins University School of Nursing, Baltimore, USA

    Minhui Liu & S. L. Szanton

  3. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA

    S. L. Szanton

Authors
  1. F. Ge
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  2. Minhui Liu
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  3. Siyuan Tang
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  4. Y. Lu
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  5. S. L. Szanton
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Corresponding author

Correspondence to Minhui Liu.

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Ge, F., Liu, M., Tang, S. et al. Assessing Frailty in Chinese Nursing Home Older Adults: A Comparison between the Frail-NH Scale and Frailty Index. J Nutr Health Aging 23, 291–298 (2019). https://doi.org/10.1007/s12603-019-1156-3

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  • DOI: https://doi.org/10.1007/s12603-019-1156-3

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