Preinjury Physical Function and Frailty in Injured Older Adults: Self- Versus Proxy Responses

To determine the extent to which proxy respondents can provide reliable reports.

Prospective cohort study.

Level I trauma center.

Seventy-seven older adults (≥65, median 73.0, interquartile range 67-80; 53% female) admitted to three services (trauma, geriatrics, orthopedics) with primary injury diagnoses over a 6-month period and their proxies (43% spouses, 44% children, 5% siblings, 8% friends or other relatives).

Three brief screening instruments (Vulnerable Elders Survey-13 (VES-13), modified Barthel Index (mBI), Life Space Assessment (LSA)) for physical function and frailty were administered to older adults and their proxies within 48 hours of admission. Data analysis included frequencies, percentages, intraclass correlations, and Kappa statistics.

Approximately 47% (n = 36) of the proxies lived with the older adults. Perfect agreement and 90% agreement between older adults and proxies: There was perfect agreement for 39 (51%) dyads and a difference of 1 or less (range 1-10) for 66 (86%) on the VES-13, perfect agreement for 48 (62%) and a difference of two or less (range 0-20) for 69 (89%) on the mBI, and perfect agreement for 27 (35%) and a difference of 12 or less (range 0-120) for 55 (71%) on the LSA.

Proxy reports of older adults' preinjury physical function and frailty are in an acceptable range of agreement with those of the older adults. Using proxy reports when people cannot provide information on themselves may facilitate care management and goal setting.