The Frail Elderly Functional Assessment questionnaire: its responsiveness and validity in alternative settings

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Clinical Assessment

Background:

• Frail elderly individuals often experience functional decline.
• Accurate assessment tools are crucial for monitoring changes in this population.
• The Frail Elderly Functional Assessment (FEFA) questionnaire's responsiveness and validity in diverse administration settings require evaluation.

Purpose of the Study:

• To assess the responsiveness of the FEFA questionnaire to low-level functional tasks in a frail elderly cohort.
• To determine the validity of the FEFA questionnaire when administered via telephone or by a caregiver proxy.

Main Methods:

• A prospective clinical trial involving 58 elderly patients across rehabilitation and outpatient settings.
• Serial administration of the FEFA questionnaire with direct observation of functional tasks for validity.
• Repeat measures within 1-2 weeks to assess responsiveness using various statistical methods (Guyatt technique, effect size, standardized response means).
• Kappa statistic and regression analyses evaluated validity for telephone and caregiver proxy administration.

Main Results:

• The FEFA questionnaire demonstrated excellent responsiveness to functional changes.
• High agreement (83%) was observed between questionnaire responses and direct task performance.
• Significant correlations were found between changes in FEFA scores and performance testing (r2 = .33, p = .01).
• Telephone and caregiver proxy administration showed high validity (correlations of .99 and .92, respectively).

Conclusions:

• The FEFA questionnaire is a responsive and valid tool for assessing functional status in frail elderly individuals.
• The questionnaire maintains its validity when administered remotely via telephone or through a caregiver proxy.
• FEFA is suitable for diverse clinical applications in geriatric care and rehabilitation settings.