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FRAIL-NH predicts outcomes in long term care

  • Published:
The journal of nutrition, health & aging

Abstract

Background/Objectives

To investigate the predictive validity of the short, simple FRAIL-NH frailty screening tool in the long term care population and to then compare the predictive validity with the frailty index (FI) for 6-month adverse health outcomes.

Design

Retrospective study using the Minimum Data Set (MDS) 3.0 and chart review from June-December 2014.

Setting

Two Long Term Care Facilities in Saint Louis, MO.

Participants

270 patients ages ≥ 65 years old residing in long term care.

Measurements

Frailty was measured using the FRAIL-NH and Frailty Index (FI) criteria. Adverse outcomes measured at 6-month follow-up included falls, hospitalizations, and hospice enrollment/mortality.

Results

Based on screening tool used frailty prevalence was 48.7% for FRAIL-NH and 30.3% for FI. The FRAIL-NH pre-frail (Adjusted Odds Ratio [AOR]=2.62; 95% Confidence Interval [CI]=1.25–5.54; p=0.11) classification was associated with 6 month risk of falling and mortality/hospice enrollment was associated with the frail classification, AOR=3.96 (1.44–10.87, p=0.007). Combining the pre-frail and frail categories both measures predicted 6 month mortality with the FRAIL-NH being the strongest predictor (AOR=3.36; 95%CI=1.26–8.98; p=0.016) and the FI was a more modest predictor with an AOR of 2.28; 95%CI=1.01–5.15; p=0.047. When directly comparing the FRAIL-NH to the FI, the FRAIL-NH pre-frail were at increased risk of falling, AOR=2.42 (1.11–5.92, p=0.027) and the FRAIL-NH frail were at increased risk of hospice enrollment/death, OR=3.25 (1.04–10.86) p=0.044.

Conclusion

In comparison to the FI, the FRAIL-NH preformed just as well at screening for frailty and was a slightly better predictor of adverse outcomes. The FRAIL-NH is a brief, easy-to-administer frailty screening tool appropriate for long term care patients and predicts increased risk of falls in the pre-frail and mortality/hospice enrollment in the frail.

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Author information

Authors and Affiliations

  1. Division of Geriatric Medicine, Saint Louis University, St. Louis, MO, USA

    Ellen W. Kaehr

  2. Class of 2018, Saint Louis University School of Medicine, St. Louis, MO, USA

    L. C. Pape

  3. Department of Neurology and Psychiatry, Saint Louis University, St. Louis, MO, USA

    T. K. Malmstrom

  4. Division of Geriatric Medicine, Saint Louis University, St. Louis, MO, USA

    John E. Morley

  5. Division of Geriatrics, Department of Internal Medicine, 1402 South Grad Boulevard, St. Louis, MO, 63104, USA

    Ellen W. Kaehr & John E. Morley

Authors
  1. Ellen W. Kaehr
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  2. L. C. Pape
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  3. T. K. Malmstrom
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  4. John E. Morley
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Corresponding authors

Correspondence to Ellen W. Kaehr or John E. Morley.

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Kaehr, E.W., Pape, L.C., Malmstrom, T.K. et al. FRAIL-NH predicts outcomes in long term care. J Nutr Health Aging 20, 192–198 (2016). https://doi.org/10.1007/s12603-016-0682-5

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  • DOI: https://doi.org/10.1007/s12603-016-0682-5

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