van der Vorst Anne, Zijlstra G A Rixt, De Witte Nico, De Lepeleire Jan, Kempen Gertrudis I J M, Schols Jos M G A
Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium.
Eur Geriatr Med. 2018 Aug;9(4):501-507. doi: 10.1007/s41999-018-0067-x. Epub 2018 May 24.
Timely detection of multidimensional frailty is important to prevent further negative outcomes. Perspectives of general practitioners (GPs) or informal caregivers might serve as a first, global screener to identify older people in need of a more extended assessment. Therefore, we aimed to investigate whether proxy assessments are associated with older people's self-reported environmental, physical, psychological, social and overall frailty.
A cross-sectional study was conducted on 78 community-dwelling people aged 60 years and over, their GPs (n = 57) and informal caregivers (n = 50). Self-reported frailty was assessed with the Comprehensive Frailty Assessment Instrument. GPs and informal caregivers rated each frailty domain and overall frailty on a scale of 0 (not frail at all) to 10 (severely frail). Associations between proxy scores and self-reported frailty were examined by correlation analyses.
Significant low to moderate associations were found between (1) self-reported physical frailty and physical frailty scores given by the GPs (r = 0.366, p ≤ 0.01) and informal caregivers (r = 0.305, p ≤ 0.05), and (2) self-reported psychological frailty and psychological frailty scores given by the GPs (r = 0.230, p ≤ 0.05) and informal caregivers (r = 0.254, p ≤ 0.05). No significant associations were found between proxy scores and self-reported environmental, social and overall frailty.
Global proxy scores as short, subjective screeners for detecting frailty cannot completely replace self-reported frailty. Nonetheless, low to moderate correlations were found for physical and psychological frailty ratings, suggesting that proxy scores might be of value as a first sign of something being wrong for these domains.
及时检测多维衰弱对于预防进一步的负面结果很重要。全科医生（GP）或非正式照料者的看法可能作为初步的整体筛查工具，以识别需要更全面评估的老年人。因此，我们旨在调查代理评估是否与老年人自我报告的环境、身体、心理、社会及整体衰弱相关。
对78名年龄在60岁及以上的社区居住者、他们的全科医生（n = 57）和非正式照料者（n = 50）进行了一项横断面研究。使用综合衰弱评估工具评估自我报告的衰弱情况。全科医生和非正式照料者对每个衰弱领域及整体衰弱程度按0（完全不衰弱）至10（严重衰弱）进行评分。通过相关性分析检验代理评分与自我报告的衰弱之间的关联。
在以下方面发现了显著的低至中度关联：（1）自我报告的身体衰弱与全科医生给出的身体衰弱评分（r = 0.366，p≤0.01）和非正式照料者给出的评分（r = 0.305，p≤0.05）之间；（2）自我报告的心理衰弱与全科医生给出的心理衰弱评分（r = 0.230，p≤0.05）和非正式照料者给出的评分（r = 0.254，p≤0.05）之间。在代理评分与自我报告的环境、社会及整体衰弱之间未发现显著关联。
作为检测衰弱的简短主观筛查工具，整体代理评分不能完全替代自我报告的衰弱情况。尽管如此，在身体和心理衰弱评分方面发现了低至中度的相关性，这表明代理评分可能作为这些领域出现问题的初步迹象具有一定价值。
