Application of the (fr)AGILE scale in the evaluation of multidimensional frailty in elderly inpatients from internal medicine wards: a cross-sectional observational study

Ying Ma; Dongxin Sui; Shaozhong Yang; Ningning Fang; Zhihao Wang

doi:10.3389/fnagi.2023.1276250

Application of the (fr)AGILE scale in the evaluation of multidimensional frailty in elderly inpatients from internal medicine wards: a cross-sectional observational study

Front Aging Neurosci. 2024 Jan 5:15:1276250. doi: 10.3389/fnagi.2023.1276250. eCollection 2023.

Authors

Ying Ma¹, Dongxin Sui², Shaozhong Yang³, Ningning Fang³, Zhihao Wang⁴

Affiliations

¹ Department of Geriatric Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China.
² Department of Respiration, The Second Hospital of Shandong University, Jinan, Shandong, China.
³ Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
⁴ Department of Geriatric Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China.

Abstract

Background: With the rapid growth of an aging global population and proportion, the prevalence of frailty is constantly increasing. Therefore, finding a frailty assessment tool suitable for clinical application by physicians has become the primary link in the comprehensive management of frailty in elderly patients. This study used the (fr)AGILE scale to investigate the frailty status of elderly patients from internal medicine wards and identified relevant factors that affect the severity of frailty.

Method: In this study, 408 elderly inpatients in internal medicine departments of Qilu Hospital of Shandong University from May 2021 to August 2022 were enrolled as research subjects, and a cross-sectional observational study was conducted. Researchers evaluated the frailty based on the (fr)AGILE scale score. The general condition, past medical history, physical examination, laboratory examination, nutrition control score, intervention and treatment measures and other elderly patient information was collected. Logistic regression analysis was used to analyze the relevant factors that affect the severity of frailty and hospitalization costs.

Results: According to the (fr)AGILE scale score, the elderly patients were divided into groups to determine whether they were frail and the severity of the frailty. Among them, 164 patients were in the prefrailty stage, which accounted for 40.2%. There were 188 cases of mild frailty that accounted for 46.1%, and 56 cases of moderate to severe frailty that accounted for 13.7%. Decreased grip strength, elevated white blood cell levels, and low sodium and potassium are independent risk factors affecting the severity of frailty. As the severity of frailty increases, the proportion of sodium, potassium, albumin supplementation as well as anti-infection gradually increases.

Conclusion: Frailty is a common elderly syndrome with a high incidence among elderly patients in internal medicine departments. The main manifestations of frailty vary with different severity levels. Inflammation, anemia, and poor nutritional status can lead to an increase in the severity of frailty as well as blood hypercoagulability, myocardial damage, and additional supportive interventions. This ultimately leads to prolonged hospitalization and increased hospitalization costs.

Keywords: (fr)AGILE scale; cross-sectional observational study; elderly patients; frailty; hospitalization expenses.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by research grants from Taishan Scholars (No. tsqn202103146); the Natural Science Foundation of Shandong Province (ZR2023MH075; ZR2021MH181).