The assessment of frailty in older people in acute care

Aim:  Develop a measure of frailty for older acute inpatients to be performed by non‐geriatricians. Method:  The Reported Edmonton Frail Scale (REFS) was adapted from the Edmonton Frail Scale for use with Australian acute inpatients. With acute patients aged over 70 years admitted to an Australian t...

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Bibliographic Details
Published in:Australasian journal on ageing 2009-12, Vol.28 (4), p.182-188
Main Authors: Hilmer, Sarah N, Perera, Vidya, Mitchell, Sarah, Murnion, Bridin P, Dent, Jonathan, Bajorek, Beata, Matthews, Slade, Rolfson, Darryl B
Format: Article
Language:English
Subjects:
acute care
Acute Disease
acute illness
Aged
Aged, 80 and over
Australia
Comorbidity
Elderly
Female
Frail Elderly
frailty
Geriatric Assessment
geriatric medicine
Geriatrician's Clinical Impression of Frailty
Handicapped
Health
Hospitals
Humans
Male
Psychiatric Status Rating Scales
Reported Edmonton Frail Scale
Statistics
Training
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Summary:Aim:  Develop a measure of frailty for older acute inpatients to be performed by non‐geriatricians. Method:  The Reported Edmonton Frail Scale (REFS) was adapted from the Edmonton Frail Scale for use with Australian acute inpatients. With acute patients aged over 70 years admitted to an Australian teaching hospital, we validated REFS against the Geriatrician's Clinical Impression of Frailty (GCIF), measures of cognition, comorbidity and function, and assessed inter‐rater reliability. Results:  REFS was moderately correlated with GCIF (n = 105, R = 0.61, P < 0.01), Mini‐Mental State Examination impairment (n = 61, R = 0.49, P < 0.001), Charlson Comorbidity Index (n = 59, R = 0.51, P < 0.001) and Katz Daily Living Scale (n = 59, R = 0.51, P < 0.001). Inter‐rater reliability of REFS administered by two researchers without medical training was excellent (kappa = 0.84, n = 31). Conclusion:  In this cohort of older acute inpatients, REFS is a valid, reliable test of frailty, and may be a valuable research tool to assess the impact of frailty on prognosis and response to therapy.
ISSN:1440-6381
1741-6612
DOI:10.1111/j.1741-6612.2009.00367.x