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Published on: July 24, 2013
Substitution of Fried's performance-based physical frailty criteria with self-report questions
Linda P M Op Het Veld1, Henrica C W de Vet2, Erik van Rossum1
1Centre of Research Autonomy and Participation for Persons with a Chronic Illness, Faculty of Health, Zuyd University of Applied Sciences, P.O. Box 550, 6400 AN Heerlen, The Netherlands; CAPHRI, Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Objective:
To identify self-report questions that can substitute Fried's performance-based frailty measures for use in large-scale studies and daily practice.
Methods:
A cross-sectional study was conducted among community dwelling older people (65+). Based on a literature search and interviews with older people and experts, 11 questions concerning walk time and 10 on handgrip strength were selected. All participants completed these sets of self-report questions as well as the original Fried criteria (including performance-based tests). Regression analyses were performed to find the questions that best substituted the performance-based tests.
Results:
In total, 135 individuals (mean age 73.8±7.0, 58.5% female) in different stages of frailty (non-frail 38.5%, pre-frail 40.7%, frail 20.7%) were included. Regression analyses revealed four questions for walk time and two for handgrip strength. Cut-off values of three for walk time (range 0-5) and one for handgrip strength (range 0-3) seem most optimal. This resulted in a sensitivity of 69.2%, 86.1% specificity and 79.4% agreement for walk time and a sensitivity of 73.2%, 71.3% specificity and 71.9% agreement for handgrip strength. The comparison of frailty stages using frailty criteria including the performance-based measures and scores based solely on self-report questions, resulted in an observed agreement of 71.1% (kappa value=0.55).
Conclusions:
Considering the agreement between the questions and the performance-based tests, these two sets of questions might be used in settings where the performance-based tests of walk time and handgrip strength are unfeasible, such as in daily practice and large-scale research.
