Frailty assessment in the geriatric outpatient clinic

Geriatr Gerontol Int. 2014 Jan;14(1):78-83. doi: 10.1111/ggi.12057. Epub 2013 Mar 26.

Abstract

Aim: Frailty is a common phenomenon in geriatric patients. In the present translational research study, we assessed two frailty instruments (Fried 2001; Gill 2002), comparing the usefulness and scoring classifications for frailty screening in an academically affiliated geriatrics clinic.

Methods: Assessment was completed on 162 male veterans (mean age 83.7 years, 57% African American) enrolled in a geriatric clinic. The instruments' component criteria, which are well known to gerontological clinicians, were administered in a standard order and scoring was identical to original instruments.

Results: The five-item Fried frailty instrument required 15-20 min to complete; the two-item Gill frailty instrument required less than 2 min. Of the 162 participants assessed, 72 were determined to be frail by at least one of the instruments, but just 33 were frail by both instruments. Correlations between the instruments were Spearman = 0.55 (P < 0.001) and kappa = 0.25, (P < 0.001). There were no differences in frailty scores based on race, and there were equivocal results based on age, even though this was an older sample, with almost 17% ≥90 years. A total of 63% (103/162) of the sample met the criterion for weak grip strength, and decreasing grip strength correlated with increasing age (r = -0.238, P = 0.002).

Conclusion: Expedient identification of the frailty syndrome remains an unmet necessity for clinical practice. The different results by the Fried and Gill frailty instruments are likely due to differences in component domains and testing methods. The present results support previous findings that showed that grip strength might be an important indicator of increasing frailty.

Keywords: clinical medicine; frailty; function; geriatric medicine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Ambulatory Care Facilities*
  • Frail Elderly*
  • Geriatric Assessment / methods*
  • Health Services for the Aged*
  • Humans
  • Male
  • Motor Activity / physiology*
  • Sickness Impact Profile
  • United States