The Prevalence of Frailty in Elderly Inflammatory Bowel Disease Patients Varies Depending on the Scale Used

Frailty is an important predictor of adverse outcomes in inflammatory bowel diseases (IBD); however, it has not been established which is the best way to measure frailty in IBD patients.

To compare four frailty scales in elderly IBD patients and identify factors associated with this condition.

Multicentre cohort study in IBD outpatients ≥ 60 years old using four frailty scales: Fried Frailty Phenotype (FFP), FRAIL scale, Clinical Frailty Score (CFS) and SHARE-FI. Clinical-demographic data and comorbidity indices (Charlson and CIRS-G) were obtained. The agreement between scales was evaluated, and logistic regression analysis was conducted to assess the factors associated with frailty.

Six hundred and twelve patients (56.4% Crohn's disease) were enrolled from March to June 2024. Prevalence of frailty varied from 4.4% (FRAIL), 4.6% (CFS), 12.4% (SHARE-FI) up to 16.8% (FFP). The agreement between all the scales used was Fleiss' Kappa 0.25. Frailty was independently associated with polypharmacy and CIRS-G ≥ 3 on multivariate analysis of the four scales. Other factors, such as higher age, female gender, poor family support, disease duration of IBD, and clinical IBD activity were statistically associated with higher risk of frailty according to three of the four scales used.

The prevalence of frailty in elderly IBD patients varies depending on the scale used. Polypharmacy and CIRS-G ≥ 3 are associated with a higher risk of frailty, regardless of the frailty assessment tool used. Further prospective studies are needed to identify the impact of frailty in elderly IBD patients and improve treatment strategies.