Abstract
Objectives
To explore the feasibility of using the FRAIL scale in community screening of older
Chinese people aged 65 years and older, followed by clinical validation by comprehensive
geriatric assessment of those classified as pre-frail or frail.
Design
Two-phase study: screening of people aged 65 years and older by trained volunteers,
followed by comprehensive geriatric assessment by multidisciplinary staff for those
classified as pre-frail or frail.
Setting
Elderly Centers in the New Territories East Region of Hong Kong SAR China.
Participants
A total of 816 members of elderly centers attending by themselves or accompanied by
relatives.
Measurements
For phase 1, questionnaire (including demographic, lifestyle, chronic diseases) and
screening tools were administered by trained volunteers. These consist of the FRAIL
scale, SARC-F to screen for sarcopenia, and mild cognitive impairment using the abbreviated
screening for mild cognitive impairment (Abbreviated Memory Inventory for the Chinese).
Blood pressure, body mass index, and grip strength were recorded. For phase 2, comprehensive
geriatric assessment include questionnaires assessing lifestyle domain (physical activity,
nutritional status using the Mini-Nutritional Assessment-Short Form), the physical
domain (number of diseases and number of drugs, activities of daily living and instrumental
activities of daily living disabilities, geriatric syndromes, self-rated health, sleep
quality), cognitive and psychological domain (Mini-Mental State Examination, Geriatric
Depression Scale), and social domain (income, housing, living satisfaction, family
support).
Results
The prevalence of pre-frailty and frailty were 52.4% and 12.5%, respectively. The
prevalence for frailty increasing with age from 5.1% for those aged 65–69 years to
16.8% for those ≥75, being greater in women compared with men (13.9% vs 4.2%). Of
those who were pre-frail or frail (n = 529), 42.5% had sarcopenia and 60.7% had mild
cognitive impairment. Among those who were frail (n = 102), sarcopenia and mild cognitive
impairment were also frequently present: 12.8% had sarcopenia, 14.7% had mild cognitive
impairment, 63.7% had both sarcopenia and mild cognitive impairment, and only 8.8%
had neither. In phase 2, participants who were classified as pre-frail or frail (n =
529) were invited for further interviews; 255 participants (48.2%) returned. Compared
with the pre-frail group, those in the frail group were less physically active, had
higher number of chronic diseases, were taking more medications (more were taking
sleeping pills), reported more falls, rated their health as poor, had higher prevalence
of depressive symptoms and mild cognitive impairment, had higher prevalence of sarcopenia,
and a high number of activities of daily living and instrumental activities of daily
living disabilities.
Conclusion
The FRAIL scale may be used as the first step in a step care approach to detecting
frailty in the community, allowing targeted intervention to potentially retard decline
and future disability.
Keywords
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Article info
Publication history
Published online: February 24, 2015
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© 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
