FRAIL scale: Predictive validity and diagnostic test accuracy

Mark Q Thompson; Olga Theou; Graeme R Tucker; Robert J Adams; Renuka Visvanathan

doi:10.1111/ajag.12829

FRAIL scale: Predictive validity and diagnostic test accuracy

Australas J Ageing. 2020 Dec;39(4):e529-e536. doi: 10.1111/ajag.12829. Epub 2020 Aug 4.

Authors

Mark Q Thompson^{1

2}, Olga Theou^{1

3}, Graeme R Tucker¹, Robert J Adams^{4

5}, Renuka Visvanathan^{1

2

6}

Affiliations

¹ National Health and Medical Research Council (NHMRC) Centre of Research Excellence: Frailty and Healthy Ageing, University of Adelaide, Adelaide, South Australia, Australia.
² Faculty of Health and Medical Sciences, Adelaide Geriatrics Training & Research with Aged Care (G-TRAC) Centre, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.
³ Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
⁴ Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University of South Australia, Adelaide, South Australia, Australia.
⁵ Respiratory and Sleep Services, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia.
⁶ Aged and Extended Care Services, Central Adelaide Local Health Network, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.

PMID: 32748992
DOI: 10.1111/ajag.12829

Abstract

Objective: To examine the predictive validity of the FRAIL scale for mortality, and diagnostic test accuracy (DTA) against the frailty phenotype (FP).

Measurement: Frailty was measured in 846 community-dwelling adults (mean age 74.3 [SD 6.3] years, 54.8% female) using a modified FRAIL scale and modified FP. Mortality was matched to death records.

Results: The FRAIL scale demonstrated significant predictive validity for mortality up to 10 years (Frail adjHR: 2.60, P < .001). DTA findings were acceptable for specificity (86.8%) and Youden index (0.50), but not sensitivity (63.6%), or area under the receiver operator curve (auROC) (0.75). DTA estimates were more acceptable when a cut-point of ≥2 characteristics was used rather than ≥3 in the primary DTA analysis.

Conclusion: The FRAIL scale is a valid predictor of mortality. DTA estimates depend on FRAIL scale cut-point used. This instrument is a potentially useful frailty screening tool.

Keywords: Australia; frailty; mortality; screening.

MeSH terms

Aged
Diagnostic Tests, Routine
Female
Frail Elderly*
Frailty* / diagnosis
Geriatric Assessment
Humans
Independent Living
Male

Grants and funding

Resthaven Incorporated