Screening and managing frailty in older nursing home residents with Frail-VIG index: Feasibility, reliability and...

Frailty is prevalent among older nursing home residents, although there is limited evidence regarding frailty screening and management in this setting.

To evaluate the measurement properties of the Frail Index based on the Comprehensive Geriatric Assessment (Frail-VIG).

Prospective observational longitudinal study of 571 residents from 3 nursing homes. Frail-VIG scores were calculated at baseline and at 6 and 12 months. Sociodemographic variables were studied. Feasibility was assessed based on simplicity of application and requirements for score calculation. Reliability was evaluated through inter-rater agreement and test-retest assessments. Construct and content validity were examined by comparing it with other frailty indexes. Predictive validity was evaluated using log-rank tests and AUC-ROC curves for mortality prediction.

Mean (SD) resident age was 88.2 (6.5) years, and 80.6 % were women. The mortality rate was 11.4 % at 6 months and 20 % at 12 months. Calculating Frail-VIG scores required 5.15 min and no additional space or equipment, and there was low risk of missing data. The inter-rater consistency and score stability over time indicate strong reliability. The Frail-VIG maintains the characteristics of other established frailty indexes and shows strong convergent validity with the FRAIL-NH and CFS scales. Baseline scores have an AUC-ROC curve (confidence interval) of 0.69 (95 % CI, 0.63-0.76) at 6 months and 0.65 (95 % CI, 0.6-0.71) at 12 months.

The measurement properties of the Frail-VIG in older nursing home residents validate its use in this population and setting. Its predictive ability for mortality suggests important implications for advanced care planning.