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Updated: Feb 12, 2026

Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty

Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty

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Novel modification of the Reported Edmonton Frail Scale

Michael Rose¹, Allan Yang², Martina Welz¹

¹Cabrini Medical Centre, Melbourne, Victoria, Australia.

Australasian Journal on Ageing

|April 11, 2018

Abstract

Objectives:

The Reported Edmonton Frail Scale (REFS) uses clock drawing as a measure of cognition. However, many patients in the acute hospital setting present with an inability to clock-draw. We considered an alternative method for assessing cognition based on a history of cognitive impairment.

Methods:

We created a modified version of the REFS (mod-REFS), utilising the same domains as the REFS, in which a screening question of cognition substitutes the clock-drawing task. Data were collected from a prospective cohort study.

Results:

Of 181 participants, frailty measured with either the REFS or the mod-REFS found equivalence. A comparison between clock drawing and cognitive question scores demonstrated a complete agreement for 152 patients (84%), a reduction in cognition score for 25 (14%) and an increase for 4 (2%).

Conclusion:

We suggest the mod-REFS will improve the frailty assessment in the acute hospital setting, overcoming the limitations associated with clock drawing.

Keywords:

clock test cognition dementia tests frailty mental status

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