Screening for Frailty With the FRAIL Scale: A Comparison With the Phenotype Criteria

Abstract

Background: Reliable and valid frailty screening instruments are lacking. The aim of the present study was to compare the diagnostic properties of the FRAIL-BR with Fried's frailty phenotype (CHS), which has not been done.

Methods: Cross-sectional observational study of 124 older adults aged 60 or older from 2 university-based geriatric outpatient units in the state of São Paulo, Brazil. In ROC analyses, we evaluated different cutoff points and AUC areas of the FRAIL-BR compared with the CHS criteria. Also, components of both diagnostic strategies had head-to-head comparisons whenever possible.

Results: The sample was composed mostly of overweight (mean BMI = 29.5 kg/m²) women (83%) with mean age of 78.6 (±7.1) years. Prevalence of frailty varied according to the FRAIL-BR (23.3%) and the CHS criteria (14.5%) (P = .04). A cutoff of 3 points in the FRAIL-BR presented a sensitivity of 28% and specificity of 90% (P = .049). A cutoff of 2 points resulted in a sensitivity of 54% and specificity of 73% (P = .01). Comparisons of 4 FRAIL-BR items (ie, weight loss, aerobic capacity, fatigue, and physical resistance) to the respective CHS components showed an independent diagnostic property of all measures, with the exception for weight loss.

Conclusion: The FRAIL scale can be used as a screening instrument for frailty (time and cost-effective).

Keywords: Frailty; geriatric assessment; phenotype criteria; screening.