Michael Rose1, Allan Yang2, Martina Welz1, Anna Masik1, Margaret Staples3. 1. Cabrini Medical Centre, Melbourne, Victoria, Australia. 2. Monash Department of Medicine, Monash University, Melbourne, Victoria, Australia. 3. Cabrini Institute, Melbourne, Victoria, Australia.
Abstract
OBJECTIVES: The Reported Edmonton Frail Scale (REFS) uses clock drawing as a measure of cognition. However, many patients in the acute hospital setting present with an inability to clock-draw. We considered an alternative method for assessing cognition based on a history of cognitive impairment. METHODS: We created a modified version of the REFS (mod-REFS), utilising the same domains as the REFS, in which a screening question of cognition substitutes the clock-drawing task. Data were collected from a prospective cohort study. RESULTS: Of 181 participants, frailty measured with either the REFS or the mod-REFS found equivalence. A comparison between clock drawing and cognitive question scores demonstrated a complete agreement for 152 patients (84%), a reduction in cognition score for 25 (14%) and an increase for 4 (2%). CONCLUSION: We suggest the mod-REFS will improve the frailty assessment in the acute hospital setting, overcoming the limitations associated with clock drawing.
OBJECTIVES: The Reported Edmonton Frail Scale (REFS) uses clock drawing as a measure of cognition. However, many patients in the acute hospital setting present with an inability to clock-draw. We considered an alternative method for assessing cognition based on a history of cognitive impairment. METHODS: We created a modified version of the REFS (mod-REFS), utilising the same domains as the REFS, in which a screening question of cognition substitutes the clock-drawing task. Data were collected from a prospective cohort study. RESULTS: Of 181 participants, frailty measured with either the REFS or the mod-REFS found equivalence. A comparison between clock drawing and cognitive question scores demonstrated a complete agreement for 152 patients (84%), a reduction in cognition score for 25 (14%) and an increase for 4 (2%). CONCLUSION: We suggest the mod-REFS will improve the frailty assessment in the acute hospital setting, overcoming the limitations associated with clock drawing.
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