Frailty Levels in Residential Aged Care Facilities Measured Using the Frailty Index and FRAIL-NH Scale

Olga Theou; Edwin C K Tan; J Simon Bell; Tina Emery; Leonie Robson; John E Morley; Kenneth Rockwood; Renuka Visvanathan

doi:10.1111/jgs.14490

Frailty Levels in Residential Aged Care Facilities Measured Using the Frailty Index and FRAIL-NH Scale

J Am Geriatr Soc. 2016 Nov;64(11):e207-e212. doi: 10.1111/jgs.14490. Epub 2016 Oct 26.

Authors

Olga Theou^{1

2}, Edwin C K Tan³, J Simon Bell^{1

3

4}, Tina Emery⁵, Leonie Robson⁵, John E Morley^{1

6

7}, Kenneth Rockwood^{1

2}, Renuka Visvanathan^{1

8

9}

Affiliations

¹ National Health and Medical Research Council Centre of Research Excellence, Trans-disciplinary Frailty Research to Achieve Healthy Aging, South Australia, Australia.
² Geriatric Medicine, Dalhousie University and Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.
³ Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia.
⁴ Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia.
⁵ Resthaven Incorporated, Adelaide, South Australia, Australia.
⁶ Division of Geriatric Medicine, School of Medicine, Saint Louis University, St. Louis, Missouri.
⁷ Division of Endocrinology, School of Medicine, Saint Louis University, St. Louis, Missouri.
⁸ Adelaide Geriatrics Training and Research with Aged Care Centre, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
⁹ Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia.

PMID: 27783396
DOI: 10.1111/jgs.14490

Abstract

Objectives: To compare the FRAIL-NH scale with the Frailty Index in assessing frailty in residential aged care facilities.

Design: Cross-sectional.

Setting: Six Australian residential aged care facilities.

Participants: Individuals aged 65 and older (N = 383, mean aged 87.5 ± 6.2, 77.5% female).

Measurements: Frailty was assessed using the 66-item Frailty Index and the FRAIL-NH scale. Other measures examined were dementia diagnosis, level of care, resident satisfaction with care, nurse-reported resident quality of life, neuropsychiatric symptoms, and professional caregiver burden.

Results: The FRAIL-NH scale was significantly associated with the Frailty Index (correlation coefficient = 0.81, P < .001). Based on the Frailty Index, 60.8% of participants were categorized as frail and 24.4% as most frail. Based on the FRAIL-NH, 37.5% of participants were classified as frail and 35.9% as most frail. Women were assessed as being frailer than men using both tools (P = .006 for FI; P = .03 for FRAIL-NH). Frailty Index levels were higher in participants aged 95 and older (0.39 ± 0.13) than in those aged younger than 85 (0.33 ± 0.13; P = .008) and in participants born outside Australia (0.38 ± 0.13) than in those born in Australia (0.34 ± 0.13; P = .01). Both frailty tools were associated with most characteristics that would indicate higher care needs, with the Frailty Index having stronger associations with all of these measures.

Conclusion: The FRAIL-NH scale is a simple and practical method to screen for frailty in residential aged care facilities.

Keywords: FRAIL scale; Frailty Index; aged care facilities; frail elderly; long-term care; nursing home.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Activities of Daily Living
Age Factors
Aged
Aged, 80 and over
Assisted Living Facilities / statistics & numerical data*
Australia
Cross-Sectional Studies
Female
Frail Elderly* / psychology
Frail Elderly* / statistics & numerical data
Geriatric Assessment / methods
Health Status Disparities
Health Status Indicators*
Homes for the Aged / statistics & numerical data*
Humans
Male
Quality of Life*
Risk Factors
Sex Factors
Weights and Measures