Frailty Prevalence and Evaluation of the FRAIL Scale Questionnaire in Patients with Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) predisposes individuals to frailty, linked with adverse outcomes. While the Fried Frailty Index (FFI) is a well-established phenotypic tool to assess frailty, its administration is cumbersome. The FRAIL scale, simpler but not widely used in patients with IBD, presents an alternative. We aimed to assess the prevalence of frailty and compare the FRAIL scale with the FFI.

A cohort of patients with IBD underwent assessment using both the FFI and the FRAIL scale. Patients were categorized as non-frail, pre-frail, or frail. The primary outcome was frailty prevalence, while secondary outcomes included comparison of FFI and FRAIL scale and associations between frailty and disease-related factors. Statistical analyses included chi-square tests, ANOVA, Kruskal-Wallis tests, and ROC curve analysis using SPSS v27, with p < 0.05 indicating significance.

Among participants (53.5% female, median age 44), 37% were non-frail, 50% pre-frail, and 13% frail. The FRAIL scale exhibited strong correlation with the FFI for all three categories. Age showed no significant association with frailty. Frail individuals displayed higher inflammatory markers and more severe clinical disease, with frailty more prevalent in patients with UC than CD. Frail individuals also exhibited lower hemoglobin, creatinine, and albumin levels.

Frailty and pre-frailty are prevalent in patients with IBD and not necessarily linked with older age. The FRAIL scale demonstrated excellent correlation with the FFI, offering a practical tool for identifying frailty in IBD without physical measurements. Future studies should explore multivariable models incorporating frailty risk factors and interventions to mitigate adverse outcomes in patients with IBD.