Frailty in community-dwelling older people: comparing screening instruments

Area of Science:

• Gerontology
• Public Health
• Epidemiology

Background:

• Frailty is a significant geriatric condition impacting community-dwelling older adults.
• Accurate assessment tools are crucial for identifying individuals at risk and implementing timely interventions.
• Comparing existing frailty assessment instruments is essential for clinical practice and research.

Purpose of the Study:

• To compare the Edmonton Frail Scale (EFS) and Clinical-Functional Vulnerability Index-20 (CFVI-20) in community-dwelling older adults in Brazil.
• To evaluate the agreement and correlation between EFS and CFVI-20.
• To identify variables associated with frailty and clinical-functional vulnerability.

Main Methods:

• A cross-sectional study nested within a population-based household cohort.
• Kappa statistic and Pearson's correlation coefficient were used to assess agreement and correlation.
• Multiple Poisson regression analysis identified factors associated with frailty.

Main Results:

• Moderate agreement (Kappa=0.599) and strong positive correlation (r=0.755) were found between EFS and CFVI-20.
• Prevalence of frailty was 28.2% by EFS and 19.5% by CFVI-20.
• Age (≥80 years), stroke history, polypharmacy, poor self-perceived health, falls, and hospitalizations were associated with frailty by both instruments.

Conclusions:

• While EFS and CFVI-20 show moderate agreement and strong correlation, their prevalence estimates for frailty differ.
• Specific factors like education, osteoarticular disease, weight loss, and caregiver status showed differential associations with frailty depending on the instrument.
• Standardization of frailty assessment instruments is necessary for community-dwelling older populations.