H Si1, Y Jin, X Qiao, X Tian, X Liu, C Wang. 1. Cuili Wang, School of Nursing, Peking University, 100191 Beijing, China. Email: cwangpk@163.com.
Abstract
OBJECTIVE: To examine the diagnostic test accuracy (DTA) of the FRAIL-NH and four frailty screening instruments among institutionalized older adults. DESIGN: Cross-sectional study. SETTING: Institutionalized setting, Jinan, China. PARTICIPANTS: A total of 305 older adults (mean age 79.3 ± 8.4 years, 57.0% female) were enrolled from nursing homes. MEASUREMENTS: Frailty was assessed by the FRAIL-NH, Physical Frailty Phenotype (PFP), FRAIL, Tilburg Frailty Indicator (TFI), and Groningen Frailty Indicator (GFI), respectively. The Comprehensive Geriatric Assessment (CGA) was used as a reference standard of frailty. The receiver operating characteristic (ROC) curve was plotted to examine the DTA of five frailty screening instruments against the CGA. The optimal cut-point was determined by the maximum value of the Youden index (YI, calculated as sensitivity + specificity - 1). RESULTS: The prevalence of frailty ranged from 25.9% (FRAIL) to 56.4% (GFI). Areas under the curve (AUCs) against the CGA ranged from 0.80 [95% confidence interval (CI) 0.74 - 0.85: FRAIL] to 0.83 (95% CI 0.78 - 0.88: PFP). At their original cut-points, all five frailty screening instruments presented low sensitivity (32.9% - 69.3%) and high specificity (80.0% - 93.8%), as well as high positive predictive values (90.7% - 94.9%) and low negative predictive values (33.2% - 48.1%). At their optimal cut-points, the sensitivity and specificity of the FRAIL-NH, PFP, and FRAIL tended to be balanced, and their correctly classified rates (76.1% - 81.3%) and kappa values (0.465 - 0.523) increased a lot. ROC contrasts showed that all five frailty screening instruments had similarly good diagnostic accuracy (χ2: 0.0003 - 1.38, P > .05). CONCLUSION: In the institutionalized setting, the specific FRAIL-NH, self-report FRAIL, TFI, and GFI as well as hybrid PFP, show similarly good diagnostic properties in identifying frailty against the CGA.
OBJECTIVE: To examine the diagnostic test accuracy (DTA) of the FRAIL-NH and four frailty screening instruments among institutionalized older adults. DESIGN: Cross-sectional study. SETTING: Institutionalized setting, Jinan, China. PARTICIPANTS: A total of 305 older adults (mean age 79.3 ± 8.4 years, 57.0% female) were enrolled from nursing homes. MEASUREMENTS: Frailty was assessed by the FRAIL-NH, Physical Frailty Phenotype (PFP), FRAIL, Tilburg Frailty Indicator (TFI), and Groningen Frailty Indicator (GFI), respectively. The Comprehensive Geriatric Assessment (CGA) was used as a reference standard of frailty. The receiver operating characteristic (ROC) curve was plotted to examine the DTA of five frailty screening instruments against the CGA. The optimal cut-point was determined by the maximum value of the Youden index (YI, calculated as sensitivity + specificity - 1). RESULTS: The prevalence of frailty ranged from 25.9% (FRAIL) to 56.4% (GFI). Areas under the curve (AUCs) against the CGA ranged from 0.80 [95% confidence interval (CI) 0.74 - 0.85: FRAIL] to 0.83 (95% CI 0.78 - 0.88: PFP). At their original cut-points, all five frailty screening instruments presented low sensitivity (32.9% - 69.3%) and high specificity (80.0% - 93.8%), as well as high positive predictive values (90.7% - 94.9%) and low negative predictive values (33.2% - 48.1%). At their optimal cut-points, the sensitivity and specificity of the FRAIL-NH, PFP, and FRAIL tended to be balanced, and their correctly classified rates (76.1% - 81.3%) and kappa values (0.465 - 0.523) increased a lot. ROC contrasts showed that all five frailty screening instruments had similarly good diagnostic accuracy (χ2: 0.0003 - 1.38, P > .05). CONCLUSION: In the institutionalized setting, the specific FRAIL-NH, self-report FRAIL, TFI, and GFI as well as hybrid PFP, show similarly good diagnostic properties in identifying frailty against the CGA.
Entities:
Keywords:
Frailty; diagnostic test accuracy; older adults
Authors: Alberto Pilotto; Alberto Cella; Andrea Pilotto; Julia Daragjati; Nicola Veronese; Clarissa Musacchio; Anna Maria Mello; Giancarlo Logroscino; Alessandro Padovani; Camilla Prete; Francesco Panza Journal: J Am Med Dir Assoc Date: 2016-12-31 Impact factor: 4.669
Authors: Marije E Hamaker; Judith M Jonker; Sophia E de Rooij; Alinda G Vos; Carolien H Smorenburg; Barbara C van Munster Journal: Lancet Oncol Date: 2012-10 Impact factor: 41.316
Authors: Sumika Mori Lin; Márlon Juliano Romero Aliberti; Sileno de Queiroz Fortes-Filho; Juliana de Araújo Melo; Ivan Aprahamian; Claudia Kimie Suemoto; Wilson Jacob Filho Journal: J Am Med Dir Assoc Date: 2017-12-27 Impact factor: 4.669
Authors: Emanuele Rocco Villani; Davide Liborio Vetrano; Rosa Liperoti; Katie Palmer; Michael Denkinger; Henriëtte G van der Roest; Roberto Bernabei; Graziano Onder Journal: Aging Clin Exp Res Date: 2021-02-15 Impact factor: 3.636