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Screening for Frailty With the FRAIL Scale: A Comparison With the Phenotype Criteria

2017; Elsevier BV; Volume: 18; Issue: 7 Linguagem: Inglês

10.1016/j.jamda.2017.01.009

1538-9375

Iván Aprahamian, Natália Oiring de Castro Cezar, Rafael Izbicki, Sumika Mori Lin, Débora Lee Vianna Paulo, André Fattori, Marina Maria Biella, Wilson Jacob Filho, Mônica Sanches Yassuda,

Health Systems, Economic Evaluations, Quality of Life

Abstract Background Reliable and valid frailty screening instruments are lacking. The aim of the present study was to compare the diagnostic properties of the FRAIL-BR with Fried's frailty phenotype (CHS), which has not been done. Methods Cross-sectional observational study of 124 older adults aged 60 or older from 2 university-based geriatric outpatient units in the state of São Paulo, Brazil. In ROC analyses, we evaluated different cutoff points and AUC areas of the FRAIL-BR compared with the CHS criteria. Also, components of both diagnostic strategies had head-to-head comparisons whenever possible. Results The sample was composed mostly of overweight (mean BMI = 29.5 kg/m 2 ) women (83%) with mean age of 78.6 (±7.1) years. Prevalence of frailty varied according to the FRAIL-BR (23.3%) and the CHS criteria (14.5%) ( P = .04). A cutoff of 3 points in the FRAIL-BR presented a sensitivity of 28% and specificity of 90% ( P = .049). A cutoff of 2 points resulted in a sensitivity of 54% and specificity of 73% ( P = .01). Comparisons of 4 FRAIL-BR items (ie, weight loss, aerobic capacity, fatigue, and physical resistance) to the respective CHS components showed an independent diagnostic property of all measures, with the exception for weight loss. Conclusion The FRAIL scale can be used as a screening instrument for frailty (time and cost-effective).