Construction Of The Frailty Index Based On A Comprehensive Geriatric Assessment And Validity Of Its Assessment For The Elderly In Retirement Home

BackgroundFrailty,a non-specific clinical state with positive correlation with age,can increase vulnerability and decrease the ability to stressor.It is caused by the accumulation of health deficit due to the interaction of biological,cognitive function,psychological and social factors.Frailty can increase disability,hospitalization,surgical complications,mortality,etc.Evaluated and intervened in the early stage,frailty may be reversed or delayed,reducing the incidence of adverse events among elderly patients.The Frailty Index based on a Comprehensive Geriatric Assessment(FI-CGA)is a frailty assessment for the accumulation of defects in multi-dimensional health variables.It can identify frailty and determine the degree of frailty in the elderly.FI-CGA can reflect patients' biological age and predict negative outcomes.The specific number and content of FI-CGA have no unified global standard.Few researches are available on the applicability in the elderly in our country,without a frailty assessment method.MethodsA total of 99 people above 60 years old living in a nursing home were interviewed.Every participant was evaluated by a CGA.A FI-CGA was made up of a total of 36 items from the CGA.At the same time,Edmonton Frailty Scale(EFS)was given to the elderly to evaluate their frailty as control.The sensitivity and accuracy of FI-CGA as well as the correlation with the risk factors for fraity were observed.Results1.The prevalence of pre-frailty in FI-CGA and EFS were 42.4% and 22.2%,respectively,with significant difference(p<0.001)and the prevalence of frailty were31.3% and 38.4%,respectively,with no significant difference(p>0.05).2.The weighted kappa of FI-CGA and EFS was 0.643(95%CI,0.537-0.750,p<0.001),which had strong consistency,and the correlation was positive(rs=0.876,p<0.001).3.Using EFS as the gold standard,the sensitivity,specificity,positive predictive and negative predictive value and Youden index of FI-CGA were 97.7%,61.5%,92.1%,92.3%,0.592,respectively.And the AUC was 0.943(95%CI,0.903-0.984,p<0.001).4.The results of FI-CGA have showed that age,living condition,multimorbidity,depression and impairment of ADL are risk factors for frailty.ConclusionsThe FI-CGA,made up of items including geriatric syndrome,chronic diseases,grip strength and walking speed,can early identify the frailty and its related risk factors.