Association between Functional Assessment Instruments and Frailty in Older Adults: The FRADEA Study

To determine the association between functional assessment instruments and frailty.

Concurrent cohort study.

Albacete Health Area (Spain).

993 subjects aged ≥ 70 years, participating in the FRADEA Study.

The following functional instruments were applied: Barthel index, Lawton index and Short Form-Late Life Function and Disability Instrument (SF-LLFDI) as disability questionnaires; Holden´s Functional Ambulation Classification (FAC) as ambulation scale, and seven performance tests: gait speed (m/s), Timed up and go (TUG) (sec), unipodal balance time (sec), 5-chair-sit-to-stand test (sec), Short Physical Performance Battery (SPPB), hand grip strength (kg) and elbow flexion strength (kg). Frailty was assessed by Fried´s criteria. The association between functional instruments and frailty was assessed, ROC curves were constructed and the area under the curves (AUC) calculated. The best cut-point was identified for each instrument and their sensitivity (S) and specificity (SP) are described.

16.9% participants were frail. The AUC, best cut-point, S and SP for each instrument were respectively: Barthel (0.916; ≤ 85; 0.90, 0.82), Lawton (0.917; ≤ 3; 0.86, 0.93), SF-LLFDI (0.948; ≤ 90; 0.87, 0.91), FAC (0.885; ≤ 4; 0.81, 0.83), gait speed (0.938; ≤ 0.62; 0.90, 0.90), TUG (0.984; ≥ 17.8; 0.93, 0.98), unipodal balance time (0.753; ≤ 5; 0.73, 0.71), 5-chair-sit-to-stand test (0.880; ≥ 15; 0.78, 0.76), SPPB (0.956; ≤ 6; 0.88, 0.88), hand grip strength (0.807; ≤ 26; 0.75, 0.75) and elbow flexion strength (0.924; ≤ 15; 0.89, 0.87).

The best performance tests to identify frail subjects are the Timed Up and Go test, gait speed and the SPPB, and the best questionnaire is the SF-LLFDI.