A Islam1, S W Muir-Hunter, M Speechley, M Montero-Odasso. 1. Manuel Montero-Odasso, Gait and Brain Lab, Parkwood Hospital, Room A-283, 801 Commissioners Road East, London, Ontario, CANADA, N6C 5J1, Phone: (519) 685-4292 ext. 42369, Fax: (519) 685-4093, Email: mmontero@uwo.ca.
Abstract
BACKGROUND: Frailty is characterized by increased vulnerability for adverse events such as falls, fractures, placement, and death. Several frailty models have been developed, including the widely accepted Frailty Phenotype. However, the Frailty Phenotype can be difficult to apply in clinical practice. Alternatively, the Clinical Frailty Scale has been proposed based on its simplicity. To date, the Clinical Frailty Scale has not been validated against the Frailty Phenotype. OBJECTIVE: We aimed to test the inter-rater reliability of the Clinical Frailty Scale and its agreement with the Frailty Phenotype in frailty identification. DESIGN: Cross-sectional study. SETTING: Retirement community in London, Ontario, Canada. PARTICIPANTS: One hundred and four community-dwelling older adults (age ≥75 years). MEASUREMENTS: Participants were first classified using the Frailty Phenotype criteria as not frail, pre-frail or frail. Subsequently, two clinicians blinded to the first assessment, determined frailty status using the Clinical Frailty Scale. Differences between assessments were resolved by consensus. Inter-rater reliability was assessed using kappa statistics. Spearman Rho correlation coefficients evaluated the concurrent validity of the Clinical Frailty Scale against Frailty Phenotype components. RESULTS: Analysis with kappa statistic showed substantial agreement between raters in applying the Clinical Frailty Scale to the sample (κw= 0.76, 95% CI 0.68, 0.84). The Clinical Frailty Scale scores also positively correlated with an increasing number of Frailty Phenotype components (ρ=0.69, p<0.01). CONCLUSION: The Clinical Frailty Scale is reliable and comparable to the Frailty Phenotype in identifying frailty in community-dwelling older adults with the advantage of being easy to administer in clinical settings. Reliable tools to identify frailty in community-dwelling older adults may help provide timely interventions to ameliorate risk of adverse events.
BACKGROUND: Frailty is characterized by increased vulnerability for adverse events such as falls, fractures, placement, and death. Several frailty models have been developed, including the widely accepted Frailty Phenotype. However, the Frailty Phenotype can be difficult to apply in clinical practice. Alternatively, the Clinical Frailty Scale has been proposed based on its simplicity. To date, the Clinical Frailty Scale has not been validated against the Frailty Phenotype. OBJECTIVE: We aimed to test the inter-rater reliability of the Clinical Frailty Scale and its agreement with the Frailty Phenotype in frailty identification. DESIGN: Cross-sectional study. SETTING: Retirement community in London, Ontario, Canada. PARTICIPANTS: One hundred and four community-dwelling older adults (age ≥75 years). MEASUREMENTS: Participants were first classified using the Frailty Phenotype criteria as not frail, pre-frail or frail. Subsequently, two clinicians blinded to the first assessment, determined frailty status using the Clinical Frailty Scale. Differences between assessments were resolved by consensus. Inter-rater reliability was assessed using kappa statistics. Spearman Rho correlation coefficients evaluated the concurrent validity of the Clinical Frailty Scale against Frailty Phenotype components. RESULTS: Analysis with kappa statistic showed substantial agreement between raters in applying the Clinical Frailty Scale to the sample (κw= 0.76, 95% CI 0.68, 0.84). The Clinical Frailty Scale scores also positively correlated with an increasing number of Frailty Phenotype components (ρ=0.69, p<0.01). CONCLUSION: The Clinical Frailty Scale is reliable and comparable to the Frailty Phenotype in identifying frailty in community-dwelling older adults with the advantage of being easy to administer in clinical settings. Reliable tools to identify frailty in community-dwelling older adults may help provide timely interventions to ameliorate risk of adverse events.
Authors: Manuel Montero-Odasso; Nathalie van der Velde; Finbarr C Martin; Mirko Petrovic; Maw Pin Tan; Jesper Ryg; Sara Aguilar-Navarro; Neil B Alexander; Clemens Becker; Hubert Blain; Robbie Bourke; Ian D Cameron; Richard Camicioli; Lindy Clemson; Jacqueline Close; Kim Delbaere; Leilei Duan; Gustavo Duque; Suzanne M Dyer; Ellen Freiberger; David A Ganz; Fernando Gómez; Jeffrey M Hausdorff; David B Hogan; Susan M W Hunter; Jose R Jauregui; Nellie Kamkar; Rose-Anne Kenny; Sarah E Lamb; Nancy K Latham; Lewis A Lipsitz; Teresa Liu-Ambrose; Pip Logan; Stephen R Lord; Louise Mallet; David Marsh; Koen Milisen; Rogelio Moctezuma-Gallegos; Meg E Morris; Alice Nieuwboer; Monica R Perracini; Frederico Pieruccini-Faria; Alison Pighills; Catherine Said; Ervin Sejdic; Catherine Sherrington; Dawn A Skelton; Sabestina Dsouza; Mark Speechley; Susan Stark; Chris Todd; Bruce R Troen; Tischa van der Cammen; Joe Verghese; Ellen Vlaeyen; Jennifer A Watt; Tahir Masud Journal: Age Ageing Date: 2022-09-02 Impact factor: 12.782
Authors: J M Pritchard; C C Kennedy; S Karampatos; G Ioannidis; B Misiaszek; S Marr; C Patterson; T Woo; A Papaioannou Journal: BMC Geriatr Date: 2017-11-13 Impact factor: 3.921
Authors: Lisa Jane Brighton; Catherine J Evans; Morag Farquhar; Katherine Bristowe; Aleksandra Kata; Jade Higman; Margaret Ogden; Claire Nolan; Deokhee Yi; Wei Gao; Maria Koulopoulou; Sharmeen Hasan; Claire J Steves; William D-C Man; Matthew Maddocks Journal: ERJ Open Res Date: 2021-03-29