Ivan Aprahamian1, Sumika Mori Lin2, Claudia Kimie Suemoto2, Daniel Apolinario2, Natália Oiring de Castro Cezar3, Serpui Marie Elmadjian2, Wilson Jacob Filho2, Mônica Sanches Yassuda4. 1. Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil; Institute and Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, State of São Paulo, Brazil; Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, State of São Paulo, Brazil. Electronic address: ivan.aprahamian@gmail.com. 2. Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil. 3. Institute and Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, State of São Paulo, Brazil. 4. Department of Neurology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil.
Abstract
OBJECTIVES: The aim of the present study was to (1) evaluate a geriatric outpatient sample with the FRAIL scale; (2) investigate the psychometric properties of the scale; and (3) characterize different associations of the subdimensions of the scale with demographic and clinical data. DESIGN: Cross-sectional observational study. SETTING: Geriatric outpatient center a university-based hospital in São Paulo, Brazil. PARTICIPANTS: A total of 811 men and women aged 60 years or older evaluated between March 2015 and September 2015. MEASUREMENTS: A translated version of the FRAIL scale was used to evaluate frailty. A review of sociodemographic data, medical records, medication, and laboratory data was conducted. A multivariate ordinal logistic regression model was used to investigate the association between frailty categories and clinical variables. Exploratory factor analysis and 2-parameter logistic item response theory was used to evaluate the psychometric properties of the FRAIL scale. RESULTS: The sample was distributed as 13.6% robust, 48.7% prefrail, and 37.7% frail older adults. Most participants reported fatigue (72.3%). Frailty was associated with older age (P = .02), depression (P = .02), dementia (P < .001), and number of medications taken (P < .001). A 2-factor model of the FRAIL scale ("ambulation" and "resistance" namely physical performance; "fatigue," "weight loss," and "illnesses" namely health status) provided independent classifications of frailty status. Physical performance (ambulation and resistance) was strongly associated with higher age and dementia, whereas health status (fatigue, weight loss, and illnesses) was more associated with female sex and depression. CONCLUSIONS: Our results suggest the existence of 2 subdimensions of the scale, suggesting different pathways to frailty. Frailty was associated with older age, depression, dementia, and number of medications in this outpatient sample.
OBJECTIVES: The aim of the present study was to (1) evaluate a geriatric outpatient sample with the FRAIL scale; (2) investigate the psychometric properties of the scale; and (3) characterize different associations of the subdimensions of the scale with demographic and clinical data. DESIGN: Cross-sectional observational study. SETTING: Geriatric outpatient center a university-based hospital in São Paulo, Brazil. PARTICIPANTS: A total of 811 men and women aged 60 years or older evaluated between March 2015 and September 2015. MEASUREMENTS: A translated version of the FRAIL scale was used to evaluate frailty. A review of sociodemographic data, medical records, medication, and laboratory data was conducted. A multivariate ordinal logistic regression model was used to investigate the association between frailty categories and clinical variables. Exploratory factor analysis and 2-parameter logistic item response theory was used to evaluate the psychometric properties of the FRAIL scale. RESULTS: The sample was distributed as 13.6% robust, 48.7% prefrail, and 37.7% frail older adults. Most participants reported fatigue (72.3%). Frailty was associated with older age (P = .02), depression (P = .02), dementia (P < .001), and number of medications taken (P < .001). A 2-factor model of the FRAIL scale ("ambulation" and "resistance" namely physical performance; "fatigue," "weight loss," and "illnesses" namely health status) provided independent classifications of frailty status. Physical performance (ambulation and resistance) was strongly associated with higher age and dementia, whereas health status (fatigue, weight loss, and illnesses) was more associated with female sex and depression. CONCLUSIONS: Our results suggest the existence of 2 subdimensions of the scale, suggesting different pathways to frailty. Frailty was associated with older age, depression, dementia, and number of medications in this outpatient sample.
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