Huang Emma Yun-Zhi, Lam Simon Ching
Department of Social Work Zhongshan Polytechnic Zhongshan City China.
School of Nursing The Hong Kong Polytechnic University Kowloon Hong Kong SAR.
Aging Med (Milton). 2021 Sep 19;4(4):272-291. doi: 10.1002/agm2.12177. eCollection 2021 Dec.
The purposes of this review are to describe the existing research on frailty measurement of older people and to understand their characteristics, with a focus on conceptual definitions, psychometric properties, and diagnostic accuracies. We reviewed the published literature to explore if cross-cultural studies of different types of frailty measurements have been conducted and to determine their applicability in the community setting. Narrative review with limited electronic database search and cross reference searching of included studies was performed. Studies published after year 2001 were searched for using MEDLINE and CINAHL Plus databases with keywords. A total of 5144 search results were obtained, but only 42 frailty measurements were identified in 68 studies. For the type, three different measurements were indicated, namely, self-report instrument (n = 17), clinical observation assessment (n = 19), and mixed frailty assessment instrument (n = 6). Only 12 (29%) measurements examined reliability and validity. Nevertheless, over 35% did not perform any psychometric testing before applying. For diagnosis accuracies, 35 (83%) frailty measurements reported the cut-off value(s) for determining level of the frailty. However, the sensitivity (56%-89.5%) and specificity (52%-91.3%) varied. The applicability was also diverse and some frailty instruments should be only used in some specific population and mode of administration. This review provides an overview of three major types of frailty measurements used in different settings with different purposes. For estimating the prevalence of frailty of older people in a community, the self-report type may be appropriate. The psychometric properties of many reviewed instruments are reported insufficiently. The cut-off value(s) are usually suggested with diverse sensitivity and specificity. Self-report instruments, such as Groningen Frailty Indicator (GFI) and Tilburg Frailty Indicator (TFI), are the most extensively examined in terms of satisfactory psychometric properties. Thus, GFI and TFI, with the current evidence, are recommended to be used in the community setting for frailty screening tools.
本综述的目的是描述关于老年人衰弱测量的现有研究，并了解其特征，重点关注概念定义、心理测量特性和诊断准确性。我们回顾了已发表的文献，以探索是否进行了不同类型衰弱测量的跨文化研究，并确定它们在社区环境中的适用性。采用有限的电子数据库搜索和纳入研究的交叉引用搜索进行叙述性综述。使用MEDLINE和CINAHL Plus数据库，通过关键词搜索2001年以后发表的研究。共获得5144条搜索结果，但在68项研究中仅识别出42种衰弱测量方法。就类型而言，指出了三种不同的测量方法，即自我报告工具（n = 17）、临床观察评估（n = 19）和混合衰弱评估工具（n = 6）。只有12种（29%）测量方法检验了信度和效度。然而，超过35%的测量方法在应用前未进行任何心理测量测试。对于诊断准确性，35种（83%）衰弱测量方法报告了确定衰弱水平的临界值。然而，敏感性（56%-89.5%）和特异性（52%-91.3%）各不相同。适用性也各不相同，一些衰弱工具仅应在某些特定人群和管理模式中使用。本综述概述了在不同环境中用于不同目的的三种主要衰弱测量类型。对于估计社区中老年人的衰弱患病率，自我报告类型可能是合适的。许多被综述工具的心理测量特性报告不足。临界值通常具有不同的敏感性和特异性。自我报告工具，如格罗宁根衰弱指标（GFI）和蒂尔堡衰弱指标（TFI），在令人满意的心理测量特性方面得到了最广泛的检验。因此，根据目前的证据，建议在社区环境中使用GFI和TFI作为衰弱筛查工具。
