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Development and Validation of a Multidimensional Frailty Scale for Clinical Geriatric Assessment

  • Original Research
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

This study aims to develop a multidimensional frailty assessment tool including physical, psychological, and social frailty and to examine its psychometric property in a clinical setting.

Methods

Through a literature review and gathered expert perspectives, the Korean Frailty Scale (KFS, 0–6 points) was developed with six questions about weight loss, self-assessment of health status, energy loss, fatigue, social network, and support. The psychometric property was then validated in community-dwelling older adults using the Korean Frailty and Aging Cohort Survey (2016–2019). Receiver operator characteristic (ROC) analyses determined optimal cutoff scores for frail, pre-frail, and robust. The predictive validity for mortality, hospitalization, fall events, and disability, such as declines in activities of daily living (ADL) and instrumental activities of daily living (IADL) was assessed after adjusting for age, sex, education level, household income, body-mass index, smoking status, alcohol consumption, physical activity, marital status, current employment, and residence.

Results

The 2,923 participants (mean age: 76.0°3.9 years, female: 52.2%) were categorized into frail (≥3 points, 21.1%), pre-frail (1–2 points, 50.2%) and robust (0 points, 28.7%) groups. Sensitivity (88.3%), specificity (91.6%), and the area under the ROC curve (0.730) for the frail group were sufficient to be accepted as a new frailty scale. The frail group had increased risk of falling (relative risk [RR]: 1.810, 95% confidence interval: 1.354–2.420), mortality (hazard ratio, 6.596, 1.802–24.137), and IADL decline (RR, 1.638, 1.231–2.178).

Conclusion

The KFS is a new multidimensional frailty scale for clinical geriatric assessment that was confirmed as effective for predicting adverse health outcomes in Korean community-dwelling older adults.

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Funding

Funding sources: This work was supported by a grant from the Korea Health Technology R&D Project through the Korean Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Republic of Korea (grant number: HI15C3153). The funding source had no involvement in the study design, data collection, data analysis, or data interpretation of this study.

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Authors and Affiliations

  1. Department of Family Medicine, Research Institute of Medical Science, Konkuk University School of Medicine, Konkuk University Medical Center, 120-1, Neungdong-ro, Gwangjin-gu, Seoul, 05030, South Korea

    J. Shin, M. Kim & Jaekyung Choi

  2. Research Institute on Healthy Aging, Konkuk University, Seoul, South Korea

    J. Shin

Authors
  1. J. Shin
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  2. M. Kim
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  3. Jaekyung Choi
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Corresponding author

Correspondence to Jaekyung Choi.

Ethics declarations

Ethical standards: This study was approved by the Institutional Review Board (IRB) of the Clinical Research Ethics Committee of Kyung Hee University Hospital, Seoul, Korea, and all subjects provided written informed consent (No. 2015-12-103).

Conflict of interest: All of the authors declare that there were no conflicts of interest.

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Shin, J., Kim, M. & Choi, J. Development and Validation of a Multidimensional Frailty Scale for Clinical Geriatric Assessment. J Nutr Health Aging 25, 938–943 (2021). https://doi.org/10.1007/s12603-021-1652-0

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  • DOI: https://doi.org/10.1007/s12603-021-1652-0

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