Abstract
Objectives
With an aging population and increase in multimorbidity, the importance of screening
for frailty and sarcopenia has become a public health priority. Several tools to do
so exist. This study aimed to examine whether the SARC-F and Edmonton frail screening
tools are useful in clinical practice to identify at-risk patients for negative health
outcomes who would benefit from intervention.
Design
This is a cross-sectional study of patients attending medical specialist outpatient
clinics at the National University Hospital, Singapore from May 2015 to February 2016.
Measurements
Frailty and sarcopenia were identified using the Edmonton Frail Scale and SARC-F questionnaires,
respectively. Other clinically relevant data including basic demographics, presence
of caregiver, number of follow-ups, medications and hospital readmissions in the past
1 year, Charlson comorbidity index, and modified Barthel index were collected from
chart review.
Results
A total of 115 patients 65 years old and older were screened. Of the sample, 44.3%
(n = 51) of patients were sarcopenic, whereas 27.0% (n = 31) were classified as frail;
23.5% (n = 27) were both frail and sarcopenic; and 87.1% of frail patients were sarcopenic,
whereas 47.1% of sarcopenic patients were frail. Sarcopenia and frailty were associated
with a higher Charlson comorbidity index, higher likelihood of requiring a caregiver,
more medical specialty follow-ups, polypharmacy, more than 2 hospital admissions within
a year, a higher number of falls and falls with serious consequences. This affected
their perceived health status with 50.0% of robust patients rating their health excellent
compared with 19.6% of sarcopenic patients (P < .001), 9.7% of frail patients (P < .001) and sarcopenic and frail patients scoring the lowest with 3.7% (P < .001).
Conclusions
The prevalence of frailty and sarcopenia among older adults attending medical outpatient
clinic is high. Both syndromes are predictors of recurrent hospital admissions, polypharmacy,
multiple medical clinic appointments, higher rate of falls, and falls with serious
consequences. Early identification of older adults at risk of adverse health outcomes
would aid in instituting timely intervention to reduce healthcare burden and improve
quality of life.
Keywords
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Article info
Publication history
Published online: February 24, 2017
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© 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine.
