Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Department of Geriatric Medicine of Danderyd Hospital, Stockholm, Sweden.
Clin Interv Aging. 2023 Sep 26;18:1607-1618. doi: 10.2147/CIA.S411470. eCollection 2023.
Assessment of frailty is a key method to identify older people in need of holistic care. However, agreement between different frailty instrument varies. Thus, groups classified as frail by different instruments are not completely overlapping. This study evaluated differences in sociodemographic factors, cognition, functional status, and quality of life between older persons with multimorbidity who were discordantly classified by five different frailty instruments, with focus on the Clinical Frailty Scale (CFS) and Fried's Frailty Phenotype (FP).
This was a cross-sectional study in a community-dwelling setting. Inclusion criteria were as follows: ≥75 years old, ≥3 visits to the emergency department the past 18 months, and ≥3 diagnoses according to ICD-10. 450 participants were included. Frailty was assessed by CFS, FP, Short Physical Performance Battery (SPPB), Grip Strength and Walking Speed.
385 participants had data on all frailty instruments. Prevalence of frailty ranged from 34% (CFS) to 75% (SPPB). Nine percent of participants were non-frail by all instruments, 20% were frail by all instruments and 71% had discordant frailty classifications. Those who were frail according to CFS but not by the other instruments had lower cognition and functional status. Those who were frail according to FP but not CFS were, to a larger extent, women, lived alone, had higher cognitive ability and functional status.
The CFS might not identify physically frail women in older community-dwelling people with multimorbidity. They could thus be at risk of not be given the attention their frail condition need.
衰弱评估是识别需要全面护理的老年人的关键方法。然而，不同衰弱工具之间的一致性存在差异。因此，不同工具分类为衰弱的人群并非完全重叠。本研究评估了患有多种疾病的老年人在社会人口统计学因素、认知、功能状态和生活质量方面的差异，这些老年人使用五种不同的衰弱工具进行分类时存在不一致，重点关注临床虚弱量表（CFS）和弗里德的虚弱表型（FP）。
这是一项在社区居住环境中进行的横断面研究。纳入标准如下：年龄≥75 岁，过去 18 个月内急诊就诊≥3 次，根据 ICD-10 诊断≥3 次。共纳入 450 名参与者。使用 CFS、FP、短体性能电池（SPPB）、握力和行走速度评估虚弱。
385 名参与者的所有虚弱工具数据均可用。衰弱的患病率从 34%（CFS）到 75%（SPPB）不等。9%的参与者所有工具均非衰弱，20%的参与者所有工具均衰弱，71%的参与者衰弱分类不一致。根据 CFS 衰弱但其他工具不衰弱的参与者认知和功能状态较低。根据 FP 衰弱但 CFS 不衰弱的参与者，在更大程度上是女性，独居，认知能力和功能状态较高。
CFS 可能无法识别患有多种疾病的老年社区居民中身体虚弱的女性。因此，他们可能有风险得不到他们虚弱状况所需的关注。
