OBJECTIVES: To compare 3 methods of describing the frailty of older adults in nursing homes. DESIGN: Secondary analysis of a prospective cohort study. SETTING: Canadian long-term care institutions. PARTICIPANTS: Institutionalized older adults in the second clinical examination cohort of the Canadian Study of Health and Aging (CSHA-2; n = 728). MEASURES: Frailty was measured using the Cardiovascular Health Survey definition (Frail-CHS); the CSHA- Clinical Frailty Scale (CSHA-CFS) and a frailty index (FI). RESULTS: The sample was very elderly (87.7 +/- 6.7 years), disabled (83%), and showed a high level of mobility impairment (83%). Each frailty measure correlated moderately well with each other (0.61-0.71) and with a disability measure (-0.45 to -0.53) but only weakly with age (0.13-0.19). By each measure, frailty was significantly associated (P < .01) with an increased risk of mortality, disability and cognitive decline. In a model that included both the frailty-CHS definition and the Frailty Index only the latter was associated with a higher risk of mortality (P < .01 for FI, P = .18 for Frail-CHS) and decline in the 3MS (P < .01 for FI, P = .20 for the Frail-CHS definition). Both measures were significantly associated with new onset disability (P < .01). Similar results were found when both the CSHA-CFS and Frailty Index were included in the models. Random combinations of 15 variables used to make up alternate 5-item Frail-CHS definitions showed that any stratification based on 5 variables allowed tertiles of risk to be discriminated. CONCLUSIONS: Frailty is a robust concept and however defined, elderly people who are frail have worse outcomes than those who are not frail. The 3 measures showed varying ability to express grades of frailty.
OBJECTIVES: To compare 3 methods of describing the frailty of older adults in nursing homes. DESIGN: Secondary analysis of a prospective cohort study. SETTING: Canadian long-term care institutions. PARTICIPANTS: Institutionalized older adults in the second clinical examination cohort of the Canadian Study of Health and Aging (CSHA-2; n = 728). MEASURES: Frailty was measured using the Cardiovascular Health Survey definition (Frail-CHS); the CSHA- Clinical Frailty Scale (CSHA-CFS) and a frailty index (FI). RESULTS: The sample was very elderly (87.7 +/- 6.7 years), disabled (83%), and showed a high level of mobility impairment (83%). Each frailty measure correlated moderately well with each other (0.61-0.71) and with a disability measure (-0.45 to -0.53) but only weakly with age (0.13-0.19). By each measure, frailty was significantly associated (P < .01) with an increased risk of mortality, disability and cognitive decline. In a model that included both the frailty-CHS definition and the Frailty Index only the latter was associated with a higher risk of mortality (P < .01 for FI, P = .18 for Frail-CHS) and decline in the 3MS (P < .01 for FI, P = .20 for the Frail-CHS definition). Both measures were significantly associated with new onset disability (P < .01). Similar results were found when both the CSHA-CFS and Frailty Index were included in the models. Random combinations of 15 variables used to make up alternate 5-item Frail-CHS definitions showed that any stratification based on 5 variables allowed tertiles of risk to be discriminated. CONCLUSIONS: Frailty is a robust concept and however defined, elderly people who are frail have worse outcomes than those who are not frail. The 3 measures showed varying ability to express grades of frailty.
Authors: F Panza; V Solfrizzi; V Frisardi; S Maggi; D Sancarlo; F Adante; G D'Onofrio; D Seripa; A Pilotto Journal: J Nutr Health Aging Date: 2011-08 Impact factor: 4.075
Authors: Susan L Greenspan; Subashan Perera; David Nace; Kimberly S Zukowski; Mary A Ferchak; Carroll J Lee; Smita Nayak; Neil M Resnick Journal: J Am Geriatr Soc Date: 2012-02-08 Impact factor: 5.562
Authors: John E Morley; Angela Marie Abbatecola; Josep M Argiles; Vickie Baracos; Juergen Bauer; Shalender Bhasin; Tommy Cederholm; Andrew J Stewart Coats; Steven R Cummings; William J Evans; Kenneth Fearon; Luigi Ferrucci; Roger A Fielding; Jack M Guralnik; Tamara B Harris; Akio Inui; Kamyar Kalantar-Zadeh; Bridget-Anne Kirwan; Giovanni Mantovani; Maurizio Muscaritoli; Anne B Newman; Filippo Rossi-Fanelli; Giuseppe M C Rosano; Ronenn Roubenoff; Morris Schambelan; Gerald H Sokol; Thomas W Storer; Bruno Vellas; Stephan von Haehling; Shing-Shing Yeh; Stefan D Anker Journal: J Am Med Dir Assoc Date: 2011-07 Impact factor: 4.669
Authors: José Juan García-González; Carmen García-Peña; Francisco Franco-Marina; Luis Miguel Gutiérrez-Robledo Journal: BMC Geriatr Date: 2009-11-03 Impact factor: 3.921