Elderly People's Preferences for Different Organizational Models for Frailty Screening: A Discrete Choice Experiment

Frailty dimensions can be evaluated in a comprehensive geriatric assessment (CGA). As frailty is often reversible, early detection can help to maintain a person's independence. The objective of the present study was to identify organizational factors that would encourage people aged 60 years or over to agree to frailty screening.

A face-to-face discrete choice experiment was conducted to elicit older adults' preferences for five attributes of the CGA: the initiator, pre-assessment, location, schedules, and announcement of the results. To assess the relative importance of attributes and explore relationships between preferences and participant characteristics, the data were analyzed using conditional logit, mixed logit, and bivariate probit models.

A total of 224 people (women: 61.2%; mean age: 72.2 years; urban dwellers: 61.6%; caregivers for other people: 35.6%) completed the survey. The CGA initiator, schedules, and location significantly influenced the respondents' preferences. The organizational preferences varied according to the respondent's quality of life and relationship with the family physician, as well as knowledge of the CGA; while agreement to attend a CGA depended on the person's gender, living environment, socioprofessional category, and caregiver status. Ideally, the CGA should be initiated by the family physician, carried out at the family physician's office or in hospital (but not at home), and split into two parts on the same day. The CGA results should preferably be presented by the healthcare professional who carried out the assessment.

Early frailty screening by a mobile geriatric team or specifically trained professionals in a neutral location close to the older person's home might be envisaged.