Abstract
Objectives
To compare the Fried criteria for frailty diagnosis with the Frailty Screening Index
(FSI) and the fatigue, resistance, ambulation, illness, and loss of weight (FRAIL)
scale in older patients with cardiovascular disease (CVD).
Design
We conducted a retrospective 1-year follow-up cohort study of adult inpatients who
participated in a cardiac rehabilitation program between June 2016 and September 2018.
Setting and Participants
We included 1472 Japanese patients age 65 years and older with CVD. After excluding
765 patients with incomplete frailty measurements, 707 patients were included in the
analysis.
Methods
Frailty and physical function were measured before hospital discharge according to
each of the 3 definitions. Outcomes were all-cause mortality and physical dysfunction.
Results
The prevalence of frailty according to the Fried criteria, the FRAIL scale, and the
FSI was 213 (30.1%), 181 (25.6%), and 186 (26.3%), respectively. The FSI and the FRAIL
scale showed moderate agreement with the Fried criteria [vs FSI: K = 0.52, 95% confidence
interval (CI): 0.45–0.59; vs FRAIL scale: K = 0.45, 95% CI: 0.37–0.52; all P < .001]. We found a significant correlation between all-cause mortality and frailty
assessed by all of the definitions, even after multivariate adjustment [FSI: hazard
ratio (HR): 2.43, 95% CI: 1.30–4.58, P = .006; FRAIL scale: HR: 2.32, 95% CI: 1.21–4.45, P = .011; Fried criteria: HR: 1.99, 95% CI: 1.04–3.82, P = .038). However, the prediction accuracy of the FRAIL scale was higher than that
of the FSI and comparable to that of the Fried criteria for physical dysfunction.
Conclusions and Implications
The FSI and the FRAIL scale showed moderate agreement with the Fried criteria regarding
frailty diagnostic performance and had comparable prognostic value. However, only
the FRAIL scale was as accurate as the Fried criteria in screening for physical dysfunction.
Keywords
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Article info
Publication history
Published online: September 19, 2022
Footnotes
This work was partially supported by JSPS KAKENHI (Grant Number 21H03309).
Identification
Copyright
© 2022 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
