Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India.
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
Clin Interv Aging. 2021 Mar 25;16:537-547. doi: 10.2147/CIA.S292969. eCollection 2021.
Frailty is a major challenge for healthcare systems in ageing societies. This dynamic state of health is a reflection of reduced reserve in various organ systems and enhanced vulnerability to stressors. Research in this area of geriatrics and gerontology is limited in low- and middle-income countries (LMICs) like India. This study is directed at development of a culturally appropriate and validated assessment scale for frailty among older Indians.
After extensive review of the literature on existing scales, a preliminary draft scale was formed. This draft was pre- and pilot-tested to check feasibility and modified accordingly. The final scale was validated on 107 older adults by confirmatory factor analysis and was named the Frailty Assessment and Screening Tool (FAST). The Fried's frailty phenotype was also administered on the same 107 older adults and scores of both were co-related. Suitable cut-off scores were found for frail and pre-frail older adults.
The final version of the FAST consisted of 14 questions pertaining to 10 domains. It has good reliability. Cronbach's alpha co-efficient was 0.99; test-retest reliability was 0.97 and validity by confirmatory factor analysis was adequate. The Kaiser-CMeyer-Olkin (KMO) of sampling adequacy was 0.699, and Bartlett's test of sphericity was significant ( = 353.471, p < 0.001). FAST scores had a cut-off of ≥ 7/14 for frail and ≥ 5/14 for pre-frail elderly.
The FAST is a validated tool with good psychometric properties. It is expected that it will be helpful in screening pre-frail and frail older adults in India and other LMICs and guide in clinical decision making for intervention.
衰弱是老龄化社会医疗体系面临的主要挑战。这种动态的健康状态反映了各器官系统储备能力的下降和对压力源的易感性增强。在印度等中低收入国家（LMICs），老年医学和老年学领域的研究有限。本研究旨在开发一种适合印度老年人且经过验证的衰弱评估量表。
在对现有量表的文献进行广泛回顾后，形成了初步的草案量表。该草案进行了预试验和试点测试，以检查可行性并进行相应修改。最终的量表通过验证性因子分析在 107 名老年人身上进行了验证，并命名为衰弱评估和筛查工具（FAST）。同时对这 107 名老年人进行了弗莱德衰弱表型评估，对两者的评分进行了相关性分析。确定了衰弱和衰弱前期老年人的适当截断分数。
FAST 的最终版本由 14 个与 10 个领域相关的问题组成。它具有良好的可靠性。克朗巴赫α系数为 0.99；重测信度为 0.97，验证性因子分析的效度适中。Kaiser-CMeyer-Olkin（KMO）样本充足度为 0.699，Bartlett 球形检验显著（ = 353.471，p < 0.001）。FAST 评分的截断值为≥7/14 为衰弱，≥5/14 为衰弱前期。
FAST 是一种具有良好心理测量特性的验证工具。预计它将有助于筛选印度和其他 LMIC 中衰弱前期和衰弱的老年人，并为干预提供临床决策指导。
