The role of the Sunfrail tool in the screening of frailty and in integrated community-hospital care pathways: a retrospective observational study

Aging Clin Exp Res. 2022 Feb;34(2):419-427. doi: 10.1007/s40520-021-01931-x. Epub 2021 Jul 24.

Abstract

Background: One of the most problematic expression of ageing is frailty, and an approach based on its early identification is mandatory. The Sunfrail-tool (ST), a 9-item questionnaire, is a promising instrument for screening frailty.

Aims: To assess the diagnostic accuracy and the construct validity between the ST and a Comprehensive Geriatric Assessment (CGA), composed by six tests representative of the bio-psycho-social model of frailty; To verify the discriminating power of five key-questions of the ST; To investigate the role of the ST in a clinical-pathway of falls' prevention.

Methods: In this retrospective study, we enrolled 235 patients from the Frailty-Multimorbidity Lab of the University-Hospital of Parma. The STs' answers were obtained from the patient's clinical information. A patient was considered frail if at least one of the CGAs' tests resulted positive.

Results: The ST was associated with the CGA's judgement with an Area Under the Curve of 0.691 (CI 95%: 0.591-0.791). Each CGA's test was associated with the ST total score. The five key-question showed a potential discriminating power in the CGA's tests of the corresponding domains. The fall-related question of the ST was significantly associated with the Short Physical Performance Battery total score (OR: 0.839, CI 95%: 0.766-0.918), a proxy of the risk of falling.

Discussion: The results suggest that the ST can capture the complexity of frailty. The ST showed a good discriminating power, and it can guide a second-level assessment to key frailty domains and/or clinical pathways.

Conclusions: The ST is a valid and easy-to-use instrument for the screening of frailty.

Keywords: Ageing; Community nursing; Frailty; Integrated care; Primary care; Sunfrail.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Critical Pathways*
  • Frail Elderly
  • Frailty* / diagnosis
  • Geriatric Assessment
  • Hospitals
  • Humans
  • Retrospective Studies