Diagnostic Performance of INA-FRAIL and Study of Osteoporotic Fractures (SOF) Index Compared to Cardiovascular Health Study (CHS) in Diagnosing Frailty Syndrome in Older Adults with Heart Failure.

BACKGROUND

There is currently no gold standard for assessing frailty syndrome in older adults with heart failure. The Cardiovascular Health Study (CHS) is a reference standard for evaluating frailty in older adults with heart failure. Still, it requires a dynamometer and a spacious space, rendering it impractical in daily practice. The INA-FRAIL and Study of Osteoporotic Fractures (SOF) Index can often be easy to use; however, it has not been evaluated for diagnostic performance on older adults with heart failure in Indonesia. This study aimed to assess the diagnostic performance of INA-FRAIL and SOF-Index in diagnosing frailty in older adults with heart failure.

METHODS

This cross-sectional study evaluated the diagnostic performances of INA-FRAIL and SOF-Index compared to CHS as the gold standard in this study. The population was heart failure patients aged > 60 at Cipto Mangunkusumo Hospital.

RESULTS

Analysis from 81 samples shows the prevalence of frailty based on CHS (35.5%), INA-FRAIL (23.5%), and SOF-Index (8,6%). Diagnostic performance analysis of INA-FRAIL showed a sensitivity of 55,17% (95% CI 35.69-73.55), specificity 94.23% (95% CI 84.05- 98.79), and AUC 0.805 (95% CI 0.698-0.912). Diagnostic performance analysis of SOF showed 20,69% sensitivity (95% CI 7.99 - 39.72), 98.08% specificity (95% CI 89.74 - 99.95), and AUC 0.719 (95% CI 0.595 - 0.843).

CONCLUSION

INA-FRAIL and SOF-Index had a significant association with CHS. The cut-off point of INA-FRAIL ≥1 showed the highest sensitivity, while INA-FRAIL ≥2 showed the highest Youden index. The cut-off point of SOF ≥1 showed the highest sensitivity and the highest Youden index.