Frailty in Nursing Homes-A Prospective Study Comparing the FRAIL-NH and the Clinical Frailty Scale.

Frailty is common in nursing home (NH) residents, but its prevalence in German institutions is unknown. Valid and easy-to-use screening tools are needed to identify frail residents. We used the FRAIL-NH scale and the Clinical Frailty Scale (CFS) to (1) obtain the prevalence of frailty, (2) investigate the agreement between both instruments, and (3) evaluate their predictive validity for adverse health events in German NH residents. Prospective cohort study. German NH residents (n = 246, age 84 ± 8 years, 67% female). Frailty status was categorized according to FRAIL-NH (nonfrail, frail, most frail) and CFS (not frail, mild to moderately frail, severely frail). Agreement between instruments was examined by Spearman correlation, an area under the receiver operating characteristic curve (AUC) with 95% CI, and sensitivity and specificity using the "most frail" category of FRAIL-NH as reference standard. Adverse health events (death, hospital admissions, falls) were recorded for 12 months, and multivariate cox and logistic regression models calculated. According to FRAIL-NH, 71.1% were most frail, 26.4% frail, and 2.5% nonfrail. According to CFS, 66.3% were severely frail, 26.8% mild to moderately frail, and 6.9% not frail. Both scales correlated significantly (r = 0.78; R2 = 60%). The AUC was 0.92 (95% CI 0.88-0.96). Using a CFS cutoff of 7 points, sensitivity was 0.90 and specificity 0.92. The frailest groups according to both instruments had an increased risk of death [FRAIL-NH hazard ratio (HR) 2.19, 95% CI 1.21-3.99; CFS HR 2.56, 95% CI 1.43-4.58] and hospital admission [FRAIL-NH odds ratio (OR) 1.95, 95% CI 1.06-3.58; CFS OR 1.79, 95% CI 1.01-3.20] compared to less frail residents. The FRAIL-NH predicted recurrent faller status (OR 2.57, 95% CI 1.23-5.39). Frailty is highly prevalent in German NH residents. Both instruments show good agreement despite different approaches and are able to predict adverse health outcomes. Based on our findings and because of its simple administration, CFS may be an alternative to FRAIL-NH for assessing frailty in NHs.

Grosshauser FJ ，Schoene D ，Kiesswetter E ，Sieber CC ，Volkert D ... -  《-》

Predictive validity of two frailty tools for mortality in Chinese nursing home residents: frailty index based on common laboratory tests (FI-Lab) versus FRAIL-NH.

Yang M ，Zhuo Y ，Hu X ，Xie L ... -  《-》

Assessing Frailty in Chinese Nursing Home Older Adults: A Comparison between the Frail-NH Scale and Frailty Index.

Ge F ，Liu M ，Tang S ，Lu Y ，Szanton SL ... -  《-》

Cross-cultural adaptation and validation of the FRAIL-NH scale for Chinese nursing home residents: A methodological and cross-sectional study.

Frailty is a common condition in older adults, and has a particularly high prevalence among nursing home residents. Therefore, it is essential to assess frailty in nursing homes. The FRAIL-NH scale is a brief, quick-to-complete, and user-friendly measurement tool. However, it has not been used in China, and further cross-cultural adaptation and validation need to be undertaken. To cross-culturally adapt and validate the FRAIL-NH scale for Chinese nursing home residents. Methodological and cross-sectional study. Twenty-seven nursing homes in Jinan, China. Older Chinese nursing home residents (n = 353, age ≥60 years, 197 women; 156 men). Interviewers obtained data on frailty, demographics, comorbidity, physical function, nutritional status, and self-rated health. The Chinese FRAIL-NH scale version was generated using the translation-backward translation method. Psychometric properties, including internal consistency, test-retest reliability, convergent validity, criterion validity, and diagnosis accuracy were evaluated. The FRAIL-NH scale showed acceptable internal consistency (Cronbach's alpha: 0.67) and satisfactory test-retest reliability within a 1- to 2-week interval (intraclass correlation coefficient: 0.84). As expected, the FRAIL-NH scale was correlated to the validated measurements, presenting convergent validity. Using the frailty phenotype as a reference criterion, the area under the curve was 0.79. The optimal cutoff point for frailty was 2 (sensitivity: 69.90% and 77.33%) in Chinese nursing homes. The FRAIL-NH scale was significantly associated with the frailty phenotype (correlation coefficient = 0.61, P < 0.001), but showed fair agreement with it (kappa = 0.46, p < 0.001). The FRAIL-NH scale was found to be suitable for frailty measurement with acceptable validity and reliability, and the optimal cutoff point for frailty was 2. The FRAIL-NH scale can be applied in Chinese nursing homes.

Zhao M ，Mou H ，Zhu S ，Li M ，Wang K ... -  《-》

Accessing the discriminatory performance of FRAIL-NH in two-class and three-class frailty and examining its agreement with the frailty index among nursing home residents in mainland China.

Ge F ，Liu W ，Liu M ，Tang S ，Lu Y ，Hou T ... -  《BMC Geriatrics》