Creation of a new frailty scale in primary care: the Zulfiqar Frailty Scale

Abstract

Background: Preventing dependency is a public health objective. We want to evaluate the ability of the "Zulfiqar Frailty Scale" (ZFS) tool to detect frailty as defined by Fried's criteria among a group of patients aged 75 and older.

Methods: Prospective study conducted in Poitou-Charentes (France) for 12 months on patients aged 75 and over and considered autonomous in terms of the ADL scale. To be eligible, the patients could not reside in a nursing home and needed an ADL score of 4 or higher.

Results: Among the group of 200 patients (with a mean age of 81.4 years, +/- 4.82), the prevalence of frailty according to Fried's criteria was 32.5%. The prevalence of frailty according to the "Zulfiqar Frailty Scale" tool was 35.0% and all items except home confinement were significantly associated with frailty. With this tool, the threshold for identifying frailty was 3 out of 6 criteria. It was quick (average completion time of 2 minutes and 2 seconds) with a sensitivity score of 88.0% and a negative predictive value of 91.0%.

Conclusion: The "Zulfiqar Frailty Scale" tool measures frailty just as effectively as Fried's criteria, with sensitivity and negative predictive values no lower than the latter.

Keywords: Elderly; Frailty; Zulfiqar Frailty Scale (ZFS); primary care.

Figure 1

ROC curve, “ZFS” vs. FRIED score with consolidation of “pre-frail” and “robust” patients into one “non-frail” group