Can proxy assessments serve as a first screener for identifying people at risk for multidimensional frailty?

Timely detection of multidimensional frailty is important to prevent further negative outcomes. Perspectives of general practitioners (GPs) or informal caregivers might serve as a first, global screener to identify older people in need of a more extended assessment. Therefore, we aimed to investigate whether proxy assessments are associated with older people's self-reported environmental, physical, psychological, social and overall frailty.

A cross-sectional study was conducted on 78 community-dwelling people aged 60 years and over, their GPs (n = 57) and informal caregivers (n = 50). Self-reported frailty was assessed with the Comprehensive Frailty Assessment Instrument. GPs and informal caregivers rated each frailty domain and overall frailty on a scale of 0 (not frail at all) to 10 (severely frail). Associations between proxy scores and self-reported frailty were examined by correlation analyses.

Significant low to moderate associations were found between (1) self-reported physical frailty and physical frailty scores given by the GPs (r = 0.366, p ≤ 0.01) and informal caregivers (r = 0.305, p ≤ 0.05), and (2) self-reported psychological frailty and psychological frailty scores given by the GPs (r = 0.230, p ≤ 0.05) and informal caregivers (r = 0.254, p ≤ 0.05). No significant associations were found between proxy scores and self-reported environmental, social and overall frailty.

Global proxy scores as short, subjective screeners for detecting frailty cannot completely replace self-reported frailty. Nonetheless, low to moderate correlations were found for physical and psychological frailty ratings, suggesting that proxy scores might be of value as a first sign of something being wrong for these domains.