Detecting Prefrailty: Comparing Subjective Frailty Assessment and the Paulson-Lichtenberg Frailty Index

We examined the level of agreement between subjective frailty assessments (SFA) and frailty classifications derived from the validated Paulson-Lichtenberg Frailty Index (PLFI). Clinic patients (n = 202) were classified as healthy, prefrail, or frail first by screening using the PLFI and later by two geriatric nurses and two geriatricians according to SFA. Of the 202 participants (mean age = 76.7 ± 8.6), 52 (26%) were prefrail and 57 (28%) were frail based on the PLFI. Geriatrician SFA aligned with the PLFI in 43.0% of prefrail and 65.7% of frail cases. Nurse SFA aligned with the PLFI in 43.9% of prefrail and 17.0% of frail cases. There was slight-to-fair agreement between SFA and PLFI (geriatrician: Cohen's κ = .23; 95% confidence interval (CI) = [.11, .35], p < .001; nurse: Cohen's κ = .20; 95% CI = [.08, .33], p = .001). Clinician SFA did not align well with PLFI classifications.