Il-Young Jang1,2, Hee-Won Jung3,4, Chang Ki Lee2, Kwang Ho Jang5, Eun-Il Cho2, Ju Jin Jung2, Euna Park6, Juyoung Kim6,7, Young Soo Lee1, Eunju Lee1, Dae Hyun Kim8. 1. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 2. PyeongChang Health Center and County Hospital, Gangwon-Do, PyeongChang, Korea. 3. Geriatric Center, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-Do, Korea. 4. Graduate School Of Medical Science And Engineering, Korea Advanced Institute Of Science And Technology (KAIST), Daejeon, Korea. 5. Department of Psychiatry, Chuncheon National Hospital, Gangwon-Do, Korea. 6. Korea Health Promotion Institute, Seoul, Korea. 7. Korean Nurses Association, Seoul, Korea. 8. Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Abstract
AIM: To compare the five-item Korean version of the Fatigue, Resistance, Ambulation, Illnesses and Loss of weight (K-FRAIL) questionnaire versus the 28-item Kihon + 3 index (the 25-item original Kihon checklist plus multimorbidity, sensory impairment, and Timed Up and Go test) in identifying prefrail or frail older adults. METHODS: We carried out a cross-sectional analysis of 212 community-dwelling older adults (mean age 76 years; 41% male) in PyeongChang County, Korea. We compared the C statistic, sensitivity and specificity of the K-FRAIL questionnaire (range 0-5; cut-point ≥1) versus the Kihon + 3 index (range 0-31; cut-point ≥4) and the original Kihon checklist (range 0-25; cut-point ≥4) in identifying prefrail or frail individuals according to the Cardiovascular Health Study criteria. RESULTS: According to the Cardiovascular Health Study criteria, 150 individuals (70.8%) were prefrail or frail. The C statistic of the K-FRAIL questionnaire in identifying prefrail or frail individuals was lower than that of the Kihon + 3 index (0.77 vs 0.85; P = 0.022) or that of the original Kihon checklist (0.77 vs 0.84; P = 0.046). However, at the a priori cut-points, the K-FRAIL questionnaire had sensitivity (0.79 vs 0.85; P = 0.095) and specificity (0.69 vs 0.69; P = 1.000) that were not significantly different from those of the Kihon + 3 index. However, the K-FRAIL questionnaire was more sensitive (0.79 vs 0.69; P = 0.016), but less specific (0.69 vs 0.86, p = 0.018) than the original Kihon checklist. CONCLUSIONS: For frailty screening in community-dwelling older adults, the simple K-FRAIL questionnaire might not be inferior to the current standard of the Kihon + 3 index, and it might be more sensitive and less specific than the original Kihon checklist. Geriatr Gerontol Int 2017; 17: 2046-2052.
AIM: To compare the five-item Korean version of the Fatigue, Resistance, Ambulation, Illnesses and Loss of weight (K-FRAIL) questionnaire versus the 28-item Kihon + 3 index (the 25-item original Kihon checklist plus multimorbidity, sensory impairment, and Timed Up and Go test) in identifying prefrail or frail older adults. METHODS: We carried out a cross-sectional analysis of 212 community-dwelling older adults (mean age 76 years; 41% male) in PyeongChang County, Korea. We compared the C statistic, sensitivity and specificity of the K-FRAIL questionnaire (range 0-5; cut-point ≥1) versus the Kihon + 3 index (range 0-31; cut-point ≥4) and the original Kihon checklist (range 0-25; cut-point ≥4) in identifying prefrail or frail individuals according to the Cardiovascular Health Study criteria. RESULTS: According to the Cardiovascular Health Study criteria, 150 individuals (70.8%) were prefrail or frail. The C statistic of the K-FRAIL questionnaire in identifying prefrail or frail individuals was lower than that of the Kihon + 3 index (0.77 vs 0.85; P = 0.022) or that of the original Kihon checklist (0.77 vs 0.84; P = 0.046). However, at the a priori cut-points, the K-FRAIL questionnaire had sensitivity (0.79 vs 0.85; P = 0.095) and specificity (0.69 vs 0.69; P = 1.000) that were not significantly different from those of the Kihon + 3 index. However, the K-FRAIL questionnaire was more sensitive (0.79 vs 0.69; P = 0.016), but less specific (0.69 vs 0.86, p = 0.018) than the original Kihon checklist. CONCLUSIONS: For frailty screening in community-dwelling older adults, the simple K-FRAIL questionnaire might not be inferior to the current standard of the Kihon + 3 index, and it might be more sensitive and less specific than the original Kihon checklist. Geriatr Gerontol Int 2017; 17: 2046-2052.
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