Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea.
Korean J Intern Med. 2021 Mar;36(2):456-466. doi: 10.3904/kjim.2019.172. Epub 2020 Apr 17.
BACKGROUND/AIMS: We aimed to assess validity of the Korean Frailty Index (KFI) and the modified KFI (mKFI) in nationwide Korean population as screening measures for frailty status in older adults.
Analysis was performed in the records of baseline assessments of 2,886 participants in the Korean Frailty Aging Cohort study from 2016 to 2017. The KFI included eight items on a history of hospitalization, self-reported health status, polypharmacy, weight loss, mood, incontinence, sensory problems, and timed up and go test. In mKFI, timed up and go test was replaced with a question whether a person can walk around a schoolyard. Cardiovascular Health Study (CHS) frailty scale was used as a gold standard.
In study population (mean age, 76; 47.6% men), score of the KFI correlated with the CHS scale. The KFI correlated with common geriatric parameters including Activities of Daily Living, nutritional status, cognitive performance, and mood. As a construct validity, items of KFI correlated with CHS scale. As a criterion validity, sensitivity was 81.6%, specificity was 67.0% to predict frailty by CHS scale with the score of 3 or higher in KFI. The KFI and mKFI correlated with each other (R2 = 0.88), and prediction ability for frailty by CHS scale was not significantly differed between KFI and mKFI.
The KFI and mKFI are valid instruments for frailty screening and might be useful as simple frailty screening tools to identify older adults who might benefit from comprehensive geriatric assessment and integrated, multidisciplinary geriatric care services.
背景/目的：我们旨在评估韩国衰弱指数（KFI）和改良 KFI（mKFI）在韩国全国人群中的有效性，作为筛查老年人衰弱状态的指标。
对 2016 年至 2017 年韩国衰弱老龄化队列研究的 2886 名参与者的基线评估记录进行了分析。KFI 包括住院史、自我报告的健康状况、多药治疗、体重减轻、情绪、尿失禁、感觉问题和起立行走测试等 8 个项目。在 mKFI 中，起立行走测试被一个人是否能够在校园周围走动的问题所取代。心血管健康研究（CHS）衰弱量表被用作金标准。
在研究人群（平均年龄 76 岁，47.6%为男性）中，KFI 评分与 CHS 量表相关。KFI 与常见老年参数相关，包括日常生活活动、营养状况、认知表现和情绪。作为结构有效性，KFI 的项目与 CHS 量表相关。作为标准有效性，KFI 评分≥3 分预测 CHS 量表定义的衰弱的敏感性为 81.6%，特异性为 67.0%。KFI 和 mKFI 相互关联（R2=0.88），并且 KFI 和 mKFI 对 CHS 量表定义的衰弱的预测能力没有显著差异。
KFI 和 mKFI 是有效的衰弱筛查工具，可作为简单的衰弱筛查工具，用于识别可能受益于全面老年评估和综合多学科老年护理服务的老年人。
