Abstract
Objectives
The aim of this study was to develop a Fried Frailty Phenotype Questionnaire (FFPQ)
and a Japanese FRAIL (fatigue, resistance, ambulation, illnesses, and loss of weight)
scale (FRAIL-J) and to evaluate the reliability and validity of both questionnaires
in Japanese community-dwelling older adults.
Design
Cross-sectional analysis of Itoshima Frail Study (IFS).
Setting
The IFS is an ongoing community-based prospective study in Itoshima (Japan).
Participants
A total of 858 older adults age 65-75 years.
Methods
The FRAIL-J comprises 5 existing items comparable to those in original FRAIL scale
but with broader utilization in the Japanese healthcare system. In FFPQ, resistance,
ambulation, and loss of weight were the same as those in FRAIL-J. Fatigue was the
same with exhaustion in FFP and inactivity was assessed using a yes or no question.
Data including demographics, and physical and cognitive functions, and objective physical
activity was collected and analyzed in relation to both questionnaires.
Results
The FFPQ and FRAIL-J showed low internal consistency (Kuder-Richardson formula 20
coefficients = 0.32 and 0.29) and good test-retest reliability (intraclass correlation
coefficients = 0.79 and 0.72). The correlations ranged from −0.22 to 0.49 when correlating
each item with cross-sectional outcomes. Using FFP as a criterion, the ares under
the curve for FRAIL-J and FFPQ were 0.86 and 0.88, respectively. The optimal cut-off
for FRAIL-J was 2, with a higher Youden index (66.7% vs 20.3% for 3) and a high negative
predictive value (99.5%) but low positive predictive value (13.1%). As for FFPQ, either
2 or 3 was evaluated as cut-off because the Youden index (62.2% vs 58.5%) and negative
predictive value (99.7% vs 99.2%) were similar although the positive predictive value
was low (9.7% vs 33.3%). Using a 2-point cut-off, both questionnaires had slight agreement
with FFP. The highest agreement (kappa = 0.42) was found between FFP and FFPQ using
a 3-point cut-off.
Conclusions/Implications
The FFPQ and FRAIL-J can be used for frailty screening in Japanese community-dwelling
older adults.
Keywords
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Article info
Publication history
Published online: September 12, 2019
Footnotes
This work was supported by Japan Agency for Medical Research and Development (AMED).
The authors declare no conflicts of interest.
Identification
Copyright
© 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
