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Mateo-Abad M, Vrotsou K, Padilla Ruiz M, Montiel-Luque A, Saucedo Figueredo MDC, Machón M, Rivas Ruiz F, Vergara I. Use of health care services according to functional performance in community-dwelling older adults in Spain. An approach using GAMLSS models. PLoS One 2022; 17:e0277681. [PMID: 36395339 PMCID: PMC9671440 DOI: 10.1371/journal.pone.0277681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 11/01/2022] [Indexed: 11/18/2022] Open
Abstract
Functional performance in older adults is a predictor of survival and other health outcomes and its measurement is highly recommended in primary care settings. Functional performance and frailty are closely related concepts, and frailty status is associated with the use of health care services. However, there is insufficient evidence on the utilization of services profile according to the functional performance of older adults. The aim of this study was to assess the relationship between functional performance and the use of a wide range of health services in community-dwelling older adults. Generalized additive models for location, scale and shape were used to study these complex data of services utilization, from primary to hospital care. A total of 749 participants from two Spanish regions were followed up for 2 years. Of those, 276 (37%) presented low functional performance and 473 (63%) normal performance according to the Timed Up and Go test. The results showed that even after adjusting for burden of comorbidity and polypharmacy, participants with low functional performance used primary and secondary care health services more intensively, visited emergency rooms more often, and were hospitalized more frequently and for longer periods of time. A negative binomial distribution and a variant thereof were found to be the best models to describe health service utilization data. In conclusion, functionality should be considered as an important health indicator for tailoring the provision of health services for older adults.
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Affiliation(s)
- Maider Mateo-Abad
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, Donostia-San Sebastián, Gipuzkoa, España
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Salamanca, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Marbella, España
- * E-mail:
| | - Kalliopi Vrotsou
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, Donostia-San Sebastián, Gipuzkoa, España
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Salamanca, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Marbella, España
| | - María Padilla Ruiz
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Salamanca, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Marbella, España
- Unidad de Investigación, Agencia Sanitaria Costa del Sol, Marbella, Málaga, España
| | - Alonso Montiel-Luque
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Marbella, España
- Centro de Salud San Miguel, Distrito Sanitario Costa del Sol, Torremolinos, Málaga, España
| | - María del Carmen Saucedo Figueredo
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Marbella, España
- Centro de Salud Los Boliches, Distrito Sanitario Costa del Sol, Fuengirola, Málaga, España
| | - Mónica Machón
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, Donostia-San Sebastián, Gipuzkoa, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Marbella, España
| | - Francisco Rivas Ruiz
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Salamanca, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Marbella, España
- Unidad de Investigación, Agencia Sanitaria Costa del Sol, Marbella, Málaga, España
| | - Itziar Vergara
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, Donostia-San Sebastián, Gipuzkoa, España
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Salamanca, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Marbella, España
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Nan J, Duan Y, Wu S, Liao L, Li X, Zhao Y, Zhang H, Zeng X, Feng H. Perspectives of older adults, caregivers, healthcare providers on frailty screening in primary care: a systematic review and qualitative meta-synthesis. BMC Geriatr 2022; 22:482. [PMID: 35659258 PMCID: PMC9166584 DOI: 10.1186/s12877-022-03173-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/23/2022] [Indexed: 11/19/2022] Open
Abstract
Background Screening is often recommended as a first step in frailty management. Many guidelines call to implicate frailty screening into practice in the primary care setting. However, few countries or organizations implement it. Understanding and clarifying the stakeholders’ views and issues faced by the implementation is essential to the successful implementation of frailty screening. However, the systematic review on stakeholders’ views of frailty screening in primary care is decidedly limited. Our objective was to explore the perspective of older adults, caregivers, and healthcare providers on frailty screening and determine the enablers and barriers to implementing frailty screening in primary care. Methods A systematic search of six databases and other resources was conducted following JBI’s three-step search strategy. The search resulted in 7362 articles, of which 97 were identified for further assessment according to the inclusion criteria. After the full-text screening, quality assessment and data extraction were carried out using the tools from Joanna Briggs Institute (JBI). Moreover, reviewers used the approach of meta-aggregative of JBI to analyze data and synthesis the findings. Results Six studies were included. A total of 63 findings were aggregated into 12 categories and then further grouped into three synthesized findings:1) capacity of healthcare providers and older adults; 2) opportunity in the implementation of frailty screening; 3) motivation in the implementation of frailty screening. These themes can help identify what influences the implementation of screening from the perspective of stakeholders. Conclusions This meta-synthesis provides evidence on the barriers and enablers of frailty screening in primary care, from the aspects of psychological, physical, social, material, etc. However, stakeholder perspectives of frailty screening have not been adequately studied. More research and efforts are needed to explore the influencing factors and address the existing barriers. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03173-6.
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Thandi M, Brown S, Wong ST. Mapping frailty concepts to SNOMED CT. Int J Med Inform 2021; 149:104409. [PMID: 33677397 DOI: 10.1016/j.ijmedinf.2021.104409] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 01/07/2021] [Accepted: 02/01/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Frailty is considered an emerging syndrome characterized by a decrease in physiological ability to respond to stressors, leading to increased morbidity and mortality rates. Frailty is distinguished from normal age-associated decline because it is a sharp and often rapid decline rather than a gradual slowing down of general functioning. The comprehensive geriatric assessment is currently considered the gold standard for identifying frailty in older adults. The electronic version of this tool is called the eCGA and is commonly included in electronic medical records (EMR) in primary care settings. OBJECTIVES We explored the adequacy of SNOMED CT to represent frailty concepts by addressing three research questions: 1) What are the defining characteristics of frailty most commonly used in frailty assessment tools? 2) Are these characteristics captured within one or many frailty assessment tools? 3) Which data elements from existing tool(s) can be reliably mapped to existing SNOMED CT terms? METHODS We conducted a literature search to explore the defining characteristics of frailty and the most commonly used assessment tools. We compared these findings to the components of frailty captured within the eCGA. We then used a descriptive study design to manually map concepts from the eCGA to SNOMED CT. RESULTS Our literature review demonstrated that the eCGA contains all common defining characteristics of frailty. Unique assessment questions from the eCGA (n = 133) were manually mapped to SNOMED CT, using expert consensus. Of these, 72 % were direct matches, 17 % were one-to-many matches, and the remaining 11 % were non-matches. Two rounds of expert clinician mapping occurred; inter-rater reliability between the two clinicians was 0.75 (kappa). CONCLUSIONS/IMPLICATIONS The resulting list of mapped eCGA elements to SNOMED CT terms can inform revisions to existing chronic disease databases to include frailty monitoring and surveillance.
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Affiliation(s)
- M Thandi
- University of British Columbia, School of Nursing, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada.
| | - S Brown
- University of British Columbia, School of Nursing, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada.
| | - S T Wong
- University of British Columbia, Centre for Health Services and Policy Research and School of Nursing, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada.
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Rivas-Ruiz F, Machón M, Mateo-Abad M, Contreras-Fernández E, Güell C, Baro-Rodríguez L, Vrotsou K, Quirós-López R, Vergara I. Tackling frailty at primary care: evaluation of the effectiveness of a multicomponent intervention through a randomised controlled trial: study protocol. BMJ Open 2020; 10:e034591. [PMID: 32086358 PMCID: PMC7045273 DOI: 10.1136/bmjopen-2019-034591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION This project focuses on how frailty is addressed in primary healthcare (PHC) and will evaluate the effectiveness of a multifactorial intervention (considering the appropriateness of the pharmaceutical prescription, the nutritional care provided and the exercise intervention) for persons with frailty, in terms of improving their functional capacity and reducing the incidence of adverse events related to frailty. The final evaluation will be made at 12 months' follow-up. METHODS AND ANALYSIS Pragmatic multicentre cluster randomised controlled clinical trial, single blind with two arms: multifactorial intervention in PHC versus usual follow-up. The randomisation unit is the patient list and the analysis unit is the patient. In addition, a cost-effectiveness study and a qualitative study will be carried out, the latter based on semistructured interviews and focus groups. Two hundred persons (100 per study branch) all aged ≥70 years, presenting frailty, but functionally independent and resident in the community, will be recruited. A baseline evaluation will be carried out prior to the intervention, with follow-up at 6 and 12 months. The main study variables considered will be functional capacity and incidence of adverse events; the secondary variables considered will be the patients' sociodemographic characteristics, nutritional status, level of physical activity and drug consumption, together with data on comorbidity, cognitive and affective status and health-related quality of life. Data will be analysed according to the intention-to-treat principle using a 5% significance level. ETHICS AND DISSEMINATION The study will at all times be conducted in strict accordance with the provisions of the Declaration of Helsinki and with the national legislation regulating patients' autonomy. All patients recruited will be asked to provide written informed consent before taking part in the clinical trial. On completion of the study, the principal investigator expects to publish the results of this research in a peer-reviewed open access scientific journal. TRIAL REGISTRATION NUMBER ISRCTN17143761.
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Affiliation(s)
- Francisco Rivas-Ruiz
- Unidad de Investigación, Agencia Sanitaria Costa del Sol, Marbella, Málaga, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
| | - Mónica Machón
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, San Sebastián, Spain
- Instituto de Investigación en Servicios de Salud Kronikgune, Baracaldo, Spain
| | - Maider Mateo-Abad
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Instituto de Investigación en Servicios de Salud Kronikgune, Baracaldo, Spain
| | - Eugenio Contreras-Fernández
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Unidad Gestión Clínica de Prevención, Promoción y Vigilancia de la Salud, Distrito Sanitario de Atención Primaria Costa del Sol, Mijas, Málaga, Spain
| | - Carolina Güell
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, San Sebastián, Spain
- Osakidetza, Centro de salud de Altza, San Sebastián, Spain
| | - Luis Baro-Rodríguez
- Área del Medicamento, Distrito Sanitario de Atencion Primaria Costa del Sol, Mijas, Spain
| | - Kalliopi Vrotsou
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, San Sebastián, Spain
- Instituto de Investigación en Servicios de Salud Kronikgune, Baracaldo, Spain
| | - Raúl Quirós-López
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Servicio de Medicina Interna, Agencia Sanitaria Costa del Sol, Marbella, Spain
| | - Itziar Vergara
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, San Sebastián, Spain
- Instituto de Investigación en Servicios de Salud Kronikgune, Baracaldo, Spain
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Machón M, Mateo-Abad M, Clerencia-Sierra M, Güell C, Poblador-Pou B, Vrotsou K, Gimeno-Miguel A, Prados-Torres A, Vergara I. Multimorbidity and functional status in older people: a cluster analysis. Eur Geriatr Med 2020; 11:321-332. [DOI: 10.1007/s41999-020-00291-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 01/15/2020] [Indexed: 11/28/2022]
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Vergara I, Mateo-Abad M, Saucedo-Figueredo MC, Machón M, Montiel-Luque A, Vrotsou K, Nava Del Val MA, Díez-Ruiz A, Güell C, Matheu A, Bueno A, Núñez J, Rivas-Ruiz F. Description of frail older people profiles according to four screening tools applied in primary care settings: a cross sectional analysis. BMC Geriatr 2019; 19:342. [PMID: 31795949 PMCID: PMC6892171 DOI: 10.1186/s12877-019-1354-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 11/11/2019] [Indexed: 11/30/2022] Open
Abstract
Background Regarding the health care of older populations, WHO recommends shifting from disease-driven attention models towards a personalized, integrated and continuous care aimed to the maintenance and enhancement of functional capacities. Impairments in the construct of functional intrinsic capacity have been understood as the condition of frailty or vulnerability. No consensus has been yet reached regarding which tools are the most suitable for screening this kind of patients in primary care settings. Tools based on the measurement of functional performance such as Timed up and go test (TUG), Short Physical Performance battery (SPPB), self-completed questionnaires like Tilburg Frailty Indicator (TFI) and clinical judgement, as the Gerontopole Frailty Scale (GFS) may be adequate. The objective of this work is to describe and compare characteristics of community-dwelling individuals identified as vulnerable or frail by four tools applied in primary care settings. Methods Cross sectional analysis developed in primary care services in two regions of Spain. Community-dwelling independent individuals aged 70 or more willing to participate were recruited and data was collected via face-to-face interviews. Frailty was assessed by TUG, SPPB, TFI and GFST. Also socio-demographic characteristics, lifestyle habits and health status data (comorbidities, polypharmacy, self-perceived health), were collected. Multiple correspondence analysis (MCA) and cluster analysis were used to identify groups of individuals with similar characteristics. Results Eight hundred sixty-five individuals were recruited, 53% women, with a mean age of 78 years. Four clusters of participants emerge. Cluster 1 (N = 263) contained patients categorized as robust by most of the studied tools, whereas clusters 2 (N = 199), 3 (N = 183) and 4 (N = 220) grouped patients classified as frail or vulnerable by at least one of the tools. Significant differences were found between clusters. Conclusions The assessed tools identify different profiles of patients according to their theoretical construct of frailty. There is a group of patients that are identified by TUG and SPPB but not by GFS or TFI. These tools may be useful in primary care settings for the implementation of a function- driven clinical care of older patients.
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Affiliation(s)
- Itziar Vergara
- Unidad de Investigación APOSIs Gipuzkoa, Osakidetza, Instituto de Investigación Sanitaria Biodonostia, 20014, Donostia-San Sebastian, Spain. .,Instituto Biodonostia, Donostia-San Sebastian, Spain. .,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain. .,Kronikgune, Barakaldo, Spain.
| | - Maider Mateo-Abad
- Unidad de Investigación APOSIs Gipuzkoa, Osakidetza, Instituto de Investigación Sanitaria Biodonostia, 20014, Donostia-San Sebastian, Spain.,Instituto Biodonostia, Donostia-San Sebastian, Spain.,Kronikgune, Barakaldo, Spain
| | | | - Mónica Machón
- Unidad de Investigación APOSIs Gipuzkoa, Osakidetza, Instituto de Investigación Sanitaria Biodonostia, 20014, Donostia-San Sebastian, Spain.,Instituto Biodonostia, Donostia-San Sebastian, Spain.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain.,Kronikgune, Barakaldo, Spain
| | - Alonso Montiel-Luque
- Unidad Gestión Clínica San Miguel, Torremolinos. Distrito de Atención Primaria Costa del Sol, Málaga, Spain
| | - Kalliopi Vrotsou
- Unidad de Investigación APOSIs Gipuzkoa, Osakidetza, Instituto de Investigación Sanitaria Biodonostia, 20014, Donostia-San Sebastian, Spain.,Instituto Biodonostia, Donostia-San Sebastian, Spain.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain.,Kronikgune, Barakaldo, Spain
| | - María Antonia Nava Del Val
- Unidad Gestión Clínica Las Albarizas, Marbella, Distrito de Atención Primaria Costa del Sol, Málaga, Spain
| | - Ana Díez-Ruiz
- Instituto Biodonostia, Donostia-San Sebastian, Spain.,Centro de Salud Beraun, OSI Donostialdea, Osakidetza, Errenteria, Spain
| | - Carolina Güell
- Unidad de Investigación APOSIs Gipuzkoa, Osakidetza, Instituto de Investigación Sanitaria Biodonostia, 20014, Donostia-San Sebastian, Spain.,Instituto Biodonostia, Donostia-San Sebastian, Spain
| | - Ander Matheu
- Grupo de Oncología Celular, Instituto Biodonostia, San Sebastián, Spain; IKERBASQUE, Fundación Vasca para la Ciencia, Bilbao, Spain; CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Bilbao, Spain
| | - Antonio Bueno
- Centro de Salud Beraun, OSI Donostialdea, Osakidetza, Errenteria, Spain
| | - Jazmina Núñez
- Centro de Salud Beraun, OSI Donostialdea, Osakidetza, Errenteria, Spain
| | - Francisco Rivas-Ruiz
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain.,Unidad de Investigación Agencia Sanitaria Costa del Sol, Marbella, Málaga, Spain
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Rivas-Ruiz F, Machón M, Contreras-Fernández E, Vrotsou K, Padilla-Ruiz M, Díez Ruiz AI, de Mesa Berenguer Y, Vergara I. Prevalence of frailty among community-dwelling elderly persons in Spain and factors associated with it. Eur J Gen Pract 2019; 25:190-196. [PMID: 31637940 PMCID: PMC6853242 DOI: 10.1080/13814788.2019.1635113] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Background: For effective prevention and intervention, and reduction of dependency, it is essential to determine the presence of frailty in the community.Objectives: To describe the prevalence of frailty among elderly persons living independently, in two primary healthcare areas in Spain; to identify factors correlated with its presence.Methods: This descriptive cross-sectional study was conducted between May 2015 and July 2016 among non-institutionalized individuals aged ≥70 years living in the primary healthcare areas of Gipuzkoa and Costa del Sol (Spain). The main outcome variable was the prevalence of frailty (determined by modified Fried criteria). The independent study variables were sociodemographic characteristics, anthropometric data and health-related life habits.Results: The study population consisted of 855 individuals (53% women). The overall prevalence of frailty was 26.2% (Gipuzkoa 14.2%, Costa del Sol 38.0%). Using multiple logistic regression, the following factors were associated with frailty: female sex (OR: 1.98; 95%CI: 1.37-2.86); cumulative illness rating scale (OR: 1.05; 95%CI: 1.00-1.10); self-perceived health status (OR: 0.96; 95%CI: 0.95-0.97); self-perceived unhealthy lifestyle (OR: 3.37; 95%CI: 2.05-8.87); dissatisfaction with the domestic environment (OR: 2.11; 95%CI: 1.18-3.76); and cognitive impairment (OR: 4.10; 95%CI: 2.05-8.19). In the multivariable model, 'geographical area' differences persisted, with an OR of 3.51 (95%CI: 2.29-5.36) for the Costa del Sol area, using Gipuzkoa as reference.Conclusion: In this population of community-dwelling persons aged 70 years and over, the prevalence of frailty was 26%. Factors correlated with frailty were female sex, comorbidity, poorer self-perceived lifestyle and health status, and dissatisfaction with the domestic environment.
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Affiliation(s)
- Francisco Rivas-Ruiz
- Unidad de Investigación, Agencia Sanitaria Costa del Sol, Marbella, Spain.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
| | - Mónica Machón
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain.,Unidad de Investigación APOSIs Gipuzkoa, Osakidetza, Donostia-San Sebastian, Spain.,Instituto Biodonostia, Donostia-San Sebastian, Spain
| | - Eugenio Contreras-Fernández
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain.,Área de Investigación - Unidad de Gestión Clínica Prevención, Promoción y Vigilancia de la Salud. Distrito Sanitario Costa del Sol. Servicio Andaluz de Salud, Málaga, Spain
| | - Kalliopi Vrotsou
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain.,Unidad de Investigación APOSIs Gipuzkoa, Osakidetza, Donostia-San Sebastian, Spain.,Instituto Biodonostia, Donostia-San Sebastian, Spain
| | - María Padilla-Ruiz
- Unidad de Investigación, Agencia Sanitaria Costa del Sol, Marbella, Spain.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
| | - Ana Isabel Díez Ruiz
- Instituto Biodonostia, Donostia-San Sebastian, Spain.,Centro de Salud Beraun, OSI Donostialdea, Osakidetza, Renteria, Spain
| | - Yolanda de Mesa Berenguer
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain.,Unidad de Gestión Clínica de la Lobilla, Distrito Sanitario Costa del Sol, Servicio Andaluz de Salud, Estepona, Málaga, Spain
| | - Itziar Vergara
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain.,Unidad de Investigación APOSIs Gipuzkoa, Osakidetza, Donostia-San Sebastian, Spain.,Instituto Biodonostia, Donostia-San Sebastian, Spain
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Frailty Assessment Scales for the Elderly and their Application in Primary Care: A Systematic Literature Review. Zdr Varst 2019; 58:91-100. [PMID: 30984300 PMCID: PMC6455011 DOI: 10.2478/sjph-2019-0012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 02/22/2019] [Indexed: 01/12/2023] Open
Abstract
Background The increase in the elderly population is causing changes and challenges that demand a comprehensive public health response. A specific characteristic of the elderly is their frailty. Today’s problems with identifying levels of frailty are being resolved by numerous tools in the form of frailty assessment scales. This systematic review establishes which frailty assessment scales for the elderly are being used and what their applicability in primary care is like in Slovenia and around the world. Methods Documents published after 2010 were searched for in the PubMed database using keywords and other specific criteria. Results A total of 177 search hits were obtained based on various search strings. The final analysis included 28 articles, of which three were systematic literature reviews. These three covered quantitative studies, mainly consisting of observational cross-sectional surveys or cohort studies. Three other studies featured non-systematic literature reviews. Quantitative studies (mainly cross-sectional surveys or cohort studies) prevailed among the remaining 22 articles. One study had a qualitative design (Delphi method). The main outcome measures observed by all studies were frailty assessment scales for the elderly, the majority of which were evaluated on a sample of the elderly. Conclusions None of the assessment scales examined are used as the gold standard for primary care. A variety of tools are being used in clinical practice to assess frailty in elderly patients, highlighting the need for standardization and guidelines. This requires evaluating the current assessment scales in terms of validity and reliability, and suitably improving them.
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Vrotsou K, Machón M, Rivas-Ruíz F, Carrasco E, Contreras-Fernández E, Mateo-Abad M, Güell C, Vergara I. Psychometric properties of the Tilburg Frailty Indicator in older Spanish people. Arch Gerontol Geriatr 2018; 78:203-212. [PMID: 30007234 DOI: 10.1016/j.archger.2018.05.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 05/29/2018] [Accepted: 05/31/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND The Tilburg Frailty Indicator (TFI) is a 15-item scale. It diagnoses frailty in the elderly based on three domains: physical, psychological and social. A Spanish cross-cultural adaptation and its psychometric properties are presented here. MATERIALS AND METHODS Independent, non-institutionalized ≥70 year-olds were recruited. The TFI structure was assessed with Kuder-Richardson (KR-20) and confirmatory factor analyses. Sperman´s correlations (rs) with Timed Up-and-Go, Self-assessed-health, Fried criteria, Short Physical Performance Battery, Gerontopole Frailty tool, assessed convergent validity. Known groups' validity and test-retest reliability were tested. RESULTS Based on n = 856 participants, domain and total scale KR-20 were <0.70. The social domain and certain physical items did not fit adequately. Most physical and total scalers were 0.31-0.48. Social domain rs were <0.30. The TFI differentiated frail and no-frail subjects, but test-retest variation was considerable. DISCUSSION TFI applicability at different social contexts and frailty stages are worth of additional study. Certain scale aspects should be reconsidered.
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Affiliation(s)
- Kalliopi Vrotsou
- Unidad de Investigación de Atención Primaria-OSIS Gipuzkoa, Osakidetza, Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Spain; Centro de Investigación en Cronicidad Kronikgune, Barakaldo, Spain.
| | - Mónica Machón
- Unidad de Investigación de Atención Primaria-OSIS Gipuzkoa, Osakidetza, Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Spain; Centro de Investigación en Cronicidad Kronikgune, Barakaldo, Spain.
| | - Francisco Rivas-Ruíz
- Unidad de Investigación, Hospital Costa del Sol, Marbella, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Spain.
| | - Estefanía Carrasco
- Grupo de Oncología Celular, Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain; CIBER de Fragilidad y Envejecimiento Saludable (CIBERfes), Spain.
| | - Eugenio Contreras-Fernández
- Unidad Gestión Clínica de Prevención, Promoción y Vigilancia de la Salud, Distrito Sanitario Costa del Sol, Servicio Andaluz de Salud, Mijas, Málaga, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Spain.
| | - Maider Mateo-Abad
- Unidad de Investigación de Atención Primaria-OSIS Gipuzkoa, Osakidetza, Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain; Centro de Investigación en Cronicidad Kronikgune, Barakaldo, Spain.
| | - Carolina Güell
- Unidad de Investigación de Atención Primaria-OSIS Gipuzkoa, Osakidetza, Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain; Centro de Salud de Alza, OSI Donostialdea, Osakidetza, San Sebastián, Spain.
| | - Itziar Vergara
- Unidad de Investigación de Atención Primaria-OSIS Gipuzkoa, Osakidetza, Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Spain; Centro de Investigación en Cronicidad Kronikgune, Barakaldo, Spain.
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Zukeran MS, Ribeiro SML. The Importance of Nutrition in a Conceptual Framework of Frailty Syndrome. Curr Nutr Rep 2017. [DOI: 10.1007/s13668-017-0195-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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