Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2017 Nov 13;17(1):264.
doi: 10.1186/s12877-017-0623-0.

Measuring frailty in clinical practice: a comparison of physical frailty assessment methods in a geriatric out-patient clinic

J M Pritchard  1   2 , C C Kennedy  3   4 , S Karampatos  5 , G Ioannidis  3   4 , B Misiaszek  3   4 , S Marr  3   4 , C Patterson  3   4 , T Woo  3   4 , A Papaioannou  3   4   6
Affiliations
Comparative Study

Measuring frailty in clinical practice: a comparison of physical frailty assessment methods in a geriatric out-patient clinic

J M Pritchard et al. BMC Geriatr. .

Abstract

Background: The objectives of this study were to determine: 1) the prevalence of frailty using Fried's phenotype method and the Short Performance Physical Battery (SPPB), 2) agreement between frailty assessment methods, 3) the feasibility of assessing frailty using Fried's phenotype method and the SPPB.

Methods: This cross-sectional study was conducted at a geriatric out-patient clinic in Hamilton, Canada. A research assistant conducted all frailty assessments. Patients were classified as non-frail, pre-frail or frail according to Fried's phenotype method and the SPPB. Agreement among methods is reported using the Cohen kappa statistic (standard error). Feasibility data included the percent of eligible participants agreeing to attempt the frailty assessments (criterion for feasibility: ≥90% of patients agreeing to the frailty assessment), equipment required, and safety considerations. A p-value of <0.05 is considered significant.

Results: A total of 110 participants (92%) and 109 participants (91%) agreed to attempt Fried's phenotype method and SPPB, respectively. No adverse events occurred during any assessments. According to Fried's phenotype method, the prevalence of frailty and pre-frailty was 35% and 56%, respectively, and according to the SPPB, the prevalence of frailty and pre-frailty was 50% and 35%, respectively. There was fair to moderate agreement between methods for determining which participants were frail (0.488 [0.082], p < 0.001) and pre-frail (0.272 [0.084], p = 0.002).

Conclusions: Frailty and pre-frailty are common in this geriatric outpatient population, and there is fair to moderate agreement between Fried's phenotype method and the SPPB. Over 90% of the patients who were eligible for the study agreed to attempt the frailty assessments, demonstrating that according to our feasibility criteria, frailty can be assessed in this patient population. Assessing frailty may help clinicians identify high-risk patients and tailor interventions based on baseline frailty characteristics.

Keywords: Frailty; Fried; Geriatric medicine; Out-patient; Phenotype; Short performance physical battery (SPPB).

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The entire study protocol was approved by the Hamilton Integrated Research Ethics Board (HiREB). All participants or legally authorized representatives signed the informed consent form prior to participation.

Consent for publication

Not applicable.

Competing interests

JP, CK, SK, GI, TW, CP, BM, SM and AP have no competing interests to declare.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Participant recruitment flow diagram
See this image and copyright information in PMC

References

    1. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381(9868):752–762. doi: 10.1016/S0140-6736(12)62167-9. - DOI - PMC - PubMed
    1. Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, Cesari M, Chumlea WC, Doehner W, Evans J, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013;14(6):392–397. doi: 10.1016/j.jamda.2013.03.022. - DOI - PMC - PubMed
    1. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–M156. doi: 10.1093/gerona/56.3.M146. - DOI - PubMed
    1. Song X, Mitnitski A, Rockwood K. Prevalence and 10-year outcomes of frailty in older adults in relation to deficit accumulation. J Am Geriatr Soc. 2010;58(4):681–687. doi: 10.1111/j.1532-5415.2010.02764.x. - DOI - PubMed
    1. Romero-Ortuno R, Wallis S, Biram R, Keevil V. Clinical frailty adds to acute illness severity in predicting mortality in hospitalized older adults: an observational study. Eur J Intern Med. 2016;35:24–34. doi: 10.1016/j.ejim.2016.08.033. - DOI - PubMed

Publication types

LinkOut - more resources