Shin J. Liau, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 407 Royal Parade, Parkville, Victoria 3052, Australia. E-mail:
J Nutr Health Aging. 2021;25(10):1205-1216. doi: 10.1007/s12603-021-1694-3.
To investigate frailty prevalence, cross-sectional associations, predictive validity, concurrent validity, and cross-cultural adaptations of the FRAIL-NH scale.
Systematic review.
Frail residents living in nursing homes.
MEDLINE, EMBASE, CINAHL, and Cochrane Library were searched from January 2015 to June 2021 for primary studies that used the FRAIL-NH scale, irrespective of study designs and publication language.
Overall, 40 studies conducted across 20 countries utilized the FRAIL-NH scale; majority in Australia (n=14), followed by China (n=6), United States (n=3), and Spain (n=3). The scale has been translated and back-translated into Brazilian Portuguese, Chinese, and Japanese. Various cut-offs have been used, with ≥2 and ≥6 being the most common cut-offs for frail and most frail, respectively. When defined using these cut-offs, frailty prevalence varied from 15.1-79.5% (frail) to 28.5-75.0% (most frail). FRAIL-NH predicted falls (n=2), hospitalization or length of stay (n=4), functional or cognitive decline (n=4), and mortality (n=9) over a median follow-up of 12 months. FRAIL-NH has been compared to 16 other scales, and was correlated with Fried's phenotype (FP), Frailty Index (FI), and FI-Lab. Four studies reported fair-to-moderate agreements between FRAIL-NH and FI, FP, and the Comprehensive Geriatric Assessment. Ten studies assessed the sensitivity and specificity of different FRAIL-NH cut-offs, with ≥8 having the highest sensitivity (94.1%) and specificity (82.8%) for classifying residents as frail based on FI, while two studies reported an optimal cut-off of ≥2 based on FI and FP, respectively.
In seven years, the FRAIL-NH scale has been applied in 20 countries and adapted into three languages. Despite being applied with a range of cut-offs, FRAIL-NH was associated with higher care needs and demonstrated good agreement with other well-established but more complex scales. FRAIL-NH was predictive of adverse outcomes across different settings, highlighting its value in guiding care for frail residents in nursing homes.
调查衰弱的流行程度、横断面关联、预测效度、同时效度和 FRAIL-NH 量表的跨文化适应性。
系统评价。
居住在养老院的衰弱居民。
2015 年 1 月至 2021 年 6 月，我们检索了 MEDLINE、EMBASE、CINAHL 和 Cochrane 图书馆中的原始研究，这些研究使用了 FRAIL-NH 量表，无论研究设计和出版语言如何。
共有 40 项研究在 20 个国家进行，使用了 FRAIL-NH 量表；其中大多数来自澳大利亚（n=14），其次是中国（n=6）、美国（n=3）和西班牙（n=3）。该量表已被翻译成巴西葡萄牙语、中文和日语，并进行了回译。已经使用了各种截断值，其中≥2 和≥6 分别是衰弱和最衰弱的最常见截断值。当使用这些截断值定义时，衰弱的流行率从 15.1-79.5%（衰弱）到 28.5-75.0%（最衰弱）不等。FRAIL-NH 预测了跌倒（n=2）、住院或住院时间（n=4）、功能或认知下降（n=4）以及 12 个月中位随访期间的死亡率（n=9）。FRAIL-NH 已与 16 种其他量表进行了比较，并与 Fried 表型（FP）、衰弱指数（FI）和 FI-Lab 相关。四项研究报告了 FRAIL-NH 与 FI、FP 和综合老年评估之间的公平至中度一致性。十项研究评估了不同 FRAIL-NH 截断值的敏感性和特异性，≥8 对根据 FI 分类居民为衰弱的敏感性（94.1%）和特异性（82.8%）最高，而两项研究分别报告了基于 FI 和 FP 的最佳截断值≥2。
在七年内，FRAIL-NH 量表已在 20 个国家应用，并已改编成三种语言。尽管使用了一系列截断值，但 FRAIL-NH 与更高的护理需求相关，并与其他经过验证但更复杂的量表具有良好的一致性。FRAIL-NH 对不同环境下的不良结局具有预测性，这突出了其在指导养老院衰弱居民护理方面的价值。
