BACKGROUND: Frailty is a pre-disability condition in older persons providing a challenge to Health-Care Systems. Systematic reviews highlight the absence of a gold-standard for its identification. However, an approach based on initial screening by the General Practitioner (GP) seems particularly useful. On these premises, a 9-item Sunfrail Checklist (SC), was developed by a multidisciplinary group, in the context of European Sunfrail Project, and tested in the Community. OBJECTIVES: - to measure the concordance between the judgments of frailty (criterion-validity): the one formulated by the GP, using the SC, and the one subsequently expressed by a Comprehensive Geriatric Assessment Team (CGA-Team); - to determine the construct-validity through the correspondence between some checklist items related to the 3 domains (physical, cognitive and social) and the three tools used by the CGA-Team; - to measure the instrument's performance in terms of positive predictive value (PPV) and negative predictive value (NPV). DESIGN: Cross-sectional study, with a final sample-size of 95 subjects. SETTING: Two Community-Health Centers of Parma, Italy. PARTICIPANTS: Subjects aged 75 years old or more, with no disability and living in the community. MEASUREMENTS: We compared the screening capacity of the GP using the SC to that one of CGA-Team based on three tests: 4-meter Gait-Speed, Mini-Mental State Examination and Loneliness Scale. RESULTS: 95 subjects (51 women), with a mean age of 81±4 years were enrolled. According to GPs 34 subjects were frail; the CGA-Team expressed a frailty judgment on 26 subjects. The criterion-validity presented a Cohen's k of 0.353. Construct-validity was also low, with a maximum contingency-coefficient of 0.19. The analysis showed a PPV of 58.1% and a NPV equal to 84.6%. CONCLUSIONS: Our data showed a low agreement between the judgements of GP performed by SC and CGA-Team. However, the good NPV suggests the applicability of SC for screening activities in primary-care.
BACKGROUND: Frailty is a pre-disability condition in older persons providing a challenge to Health-Care Systems. Systematic reviews highlight the absence of a gold-standard for its identification. However, an approach based on initial screening by the General Practitioner (GP) seems particularly useful. On these premises, a 9-item Sunfrail Checklist (SC), was developed by a multidisciplinary group, in the context of European Sunfrail Project, and tested in the Community. OBJECTIVES: - to measure the concordance between the judgments of frailty (criterion-validity): the one formulated by the GP, using the SC, and the one subsequently expressed by a Comprehensive Geriatric Assessment Team (CGA-Team); - to determine the construct-validity through the correspondence between some checklist items related to the 3 domains (physical, cognitive and social) and the three tools used by the CGA-Team; - to measure the instrument's performance in terms of positive predictive value (PPV) and negative predictive value (NPV). DESIGN: Cross-sectional study, with a final sample-size of 95 subjects. SETTING: Two Community-Health Centers of Parma, Italy. PARTICIPANTS: Subjects aged 75 years old or more, with no disability and living in the community. MEASUREMENTS: We compared the screening capacity of the GP using the SC to that one of CGA-Team based on three tests: 4-meter Gait-Speed, Mini-Mental State Examination and Loneliness Scale. RESULTS: 95 subjects (51 women), with a mean age of 81±4 years were enrolled. According to GPs 34 subjects were frail; the CGA-Team expressed a frailty judgment on 26 subjects. The criterion-validity presented a Cohen's k of 0.353. Construct-validity was also low, with a maximum contingency-coefficient of 0.19. The analysis showed a PPV of 58.1% and a NPV equal to 84.6%. CONCLUSIONS: Our data showed a low agreement between the judgements of GP performed by SC and CGA-Team. However, the good NPV suggests the applicability of SC for screening activities in primary-care.
Authors: Fulvio Lauretani; Yari Longobucco; Francesca Ferrari Pellegrini; Aurelio Maria De Iorio; Chiara Fazio; Raffaele Federici; Elena Gallini; Umberto La Porta; Giulia Ravazzoni; Maria Federica Roberti; Marco Salvi; Irene Zucchini; Giovanna Pelà; Marcello Maggio Journal: Front Psychol Date: 2020-11-26
Authors: Maria Gabriella Melchiorre; Sabrina Quattrini; Giovanni Lamura; Marco Socci Journal: Int J Environ Res Public Health Date: 2022-03-26 Impact factor: 3.390
Authors: Maddalena Illario; Vincenzo De Luca; Gabrielle Onorato; Giovanni Tramontano; Ana Maria Carriazo; Regina Elisabeth Roller-Wirnsberger; Joao Apostolo; Patrik Eklund; Nandu Goswami; Guido Iaccarino; Maria Triassi; John Farrell; Jean Bousquet Journal: Clin Interv Aging Date: 2022-04-02 Impact factor: 4.458