Frailty prevalence and efficient screening in primary care-based memory clinics.

Area of Science:

• Gerontology
• Primary Care Medicine
• Cognitive Neurology

Background:

• Prevalence of frailty among patients with memory concerns in primary care settings is not well-established.
• Memory clinics serve a population at risk for both cognitive decline and physical frailty.

Purpose of the Study:

• To determine the prevalence of frailty in patients attending a primary care memory clinic.
• To compare frailty prevalence rates based on different screening tools.

Main Methods:

• Retrospective review of 258 patients' medical records from a primary care memory clinic.
• Frailty assessed using Fried frailty criteria (physical measures) and Clinical Frailty Scale (CFS) (functional status).
• Weighted kappa statistics used to compare agreement between Fried criteria and CFS.

Main Results:

• Frailty prevalence was 16% by Fried criteria and 48% by CFS.
• Fair agreement between Fried criteria and CFS for CFS 5+ (kappa = 0.22).
• Moderate agreement between Fried criteria and CFS for CFS 6+ (kappa = 0.47).
• Dual-trait measures (grip strength and gait speed) validated as proxies for Fried frailty.

Conclusions:

• Frailty prevalence estimates differ substantially depending on the screening measure used.
• Physical performance-based frailty screening may be more efficient in primary care memory clinic patients.
• Measure selection for frailty screening should align with study objectives and clinical context.