Diagnostic test accuracy of self-reported frailty screening instruments in identifying community-dwelling older people at risk of frailty and pre-frailty

2017 ◽  
Vol 15 (10) ◽  
pp. 2464-2468 ◽  
Author(s):  
Rachel C. Ambagtsheer ◽  
Mark Q. Thompson ◽  
Mandy M. Archibald ◽  
Mavourneen G. Casey ◽  
Timothy J. Schultz
Keyword(s):  
At Risk ◽  
Older People ◽  
Diagnostic Test ◽  
Community Dwelling ◽  
Diagnostic Test Accuracy ◽  
Test Accuracy ◽  
Screening Instruments ◽  
Community Dwelling Older People

Commonly Used Screening Instruments to Identify Frailty Among Community-Dwelling Older People in a General Practice (Primary Care) Setting: A Study of Diagnostic Test Accuracy

2019 ◽  
Vol 75 (6) ◽  
pp. 1134-1142 ◽  
Author(s):  
Rachel C Ambagtsheer ◽  
Renuka Visvanathan ◽  
Elsa Dent ◽  
Solomon Yu ◽  
Timothy J Schultz ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Older People ◽  
Diagnostic Test ◽  
Community Dwelling ◽  
Diagnostic Test Accuracy ◽  
Test Accuracy ◽  
Screening Instruments ◽  
Residential Care Facility ◽  
Index Tests

Abstract Background Rapid frailty screening remains problematic in primary care. The diagnostic test accuracy (DTA) of several screening instruments has not been sufficiently established. We evaluated the DTA of several screening instruments against two reference standards: Fried’s Frailty Phenotype [FP] and the Adelaide Frailty Index [AFI]), a self-reported questionnaire. Methods DTA study within three general practices in South Australia. We randomly recruited 243 general practice patients aged 75+ years. Eligible participants were 75+ years, proficient in English and community-dwelling. We excluded those who were receiving palliative care, hospitalized or living in a residential care facility. We calculated sensitivity, specificity, predictive values, likelihood ratios, Youden Index and area under the curve (AUC) for: Edmonton Frail Scale [EFS], FRAIL Scale Questionnaire [FQ], Gait Speed Test [GST], Groningen Frailty Indicator [GFI], Kihon Checklist [KC], Polypharmacy [POLY], PRISMA-7 [P7], Reported Edmonton Frail Scale [REFS], Self-Rated Health [SRH] and Timed Up and Go [TUG]) against FP [3+ criteria] and AFI [>0.21]. Results We obtained valid data for 228 participants, with missing scores for index tests multiply imputed. Frailty prevalence was 17.5% frail, 56.6% prefrail [FP], and 48.7% frail, 29.0% prefrail [AFI]. Of the index tests KC (Se: 85.0% [70.2–94.3]; Sp: 73.4% [66.5–79.6]) and REFS (Se: 87.5% [73.2–95.8]; Sp: 75.5% [68.8–81.5]), both against FP, showed sufficient diagnostic accuracy according to our prespecified criteria. Conclusions Two screening instruments—the KC and REFS, show the most promise for wider implementation within general practice, enabling a personalized approach to care for older people with frailty.

scholarly journals Feasibility, acceptability and diagnostic test accuracy of frailty screening instruments in community-dwelling older people within the Australian general practice setting: a study protocol for a cross-sectional study

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016663 ◽  
Author(s):  
Rachel Ambagtsheer ◽  
Renuka Visvanathan ◽  
Matteo Cesari ◽  
Solomon Yu ◽  
Mandy Archibald ◽  
...  
Keyword(s):  
General Practice ◽  
Diagnostic Test ◽  
Frailty Index ◽  
Community Dwelling ◽  
Diagnostic Test Accuracy ◽  
Test Accuracy ◽  
Screening Instruments ◽  
Frailty Phenotype ◽  
Predictive Values ◽  
Increased Risk

IntroductionFrailty is one of the most challenging aspects of population ageing due to its association with increased risk of poor health outcomes and quality of life. General practice provides an ideal setting for the prevention and management of frailty via the implementation of preventive measures such as early identification through screening.Methods and analysisOur study will evaluate the feasibility, acceptability and diagnostic test accuracy of several screening instruments in diagnosing frailty among community-dwelling Australians aged 75+ years who have recently made an appointment to see their general practitioner (GP). We will recruit 240 participants across 2 general practice sites within South Australia. We will invite eligible patients to participate and consent to the study via mail. Consenting participants will attend a screening appointment to undertake the index tests: 2 self-reported (Reported Edmonton Frail Scale and Kihon Checklist) and 5 (Frail Scale, Groningen Frailty Index, Program on Research for Integrating Services for the Maintenance of Autonomy (PRISMA-7), Edmonton Frail Scale and Gait Speed Test) administered by a practice nurse (a Registered Nurse working in general practice). We will randomise test order to reduce bias. Psychosocial measures will also be collected via questionnaire at the appointment. A blinded researcher will then administer two reference standards (the Frailty Phenotype and Adelaide Frailty Index). We will determine frailty by a cut-point of 3 of 5 criteria for the Phenotype and 9 of 42 items for the AFI. We will determine accuracy by analysis of sensitivity, specificity, predictive values and likelihood ratios. We will assess feasibility and acceptability by: 1) collecting data about the instruments prior to collection; 2) interviewing screeners after data collection; 3) conducting a pilot survey with a 10% sample of participants.Ethics and disseminationThe Torrens University Higher Research Ethics Committee has approved this study. We will disseminate findings via publication in peer-reviewed journals and presentation at relevant conferences.

We need to do better: A systematic review and meta-analysis of diagnostic test accuracy of restless legs syndrome screening instruments

2021 ◽  
Vol 58 ◽  
pp. 101461
Author(s):  
Stephany Fulda ◽  
Richard P. Allen ◽  
Christopher J. Earley ◽  
Birgit Högl ◽  
Diego Garcia-Borreguero ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Test ◽  
Restless Legs Syndrome ◽  
Meta Analysis ◽  
Diagnostic Test Accuracy ◽  
Test Accuracy ◽  
Screening Instruments ◽  
Restless Legs

scholarly journals Impact of Malnutrition on Low Muscle Mass in Community-Dwelling Older People in Singapore: Findings from the SHIELD study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 80-80
Author(s):  
Siew Ling Tey ◽  
Samuel Teong Huang Chew ◽  
Yatin Berde ◽  
Geraldine Baggs ◽  
Choon How How ◽  
...  
Keyword(s):  
At Risk ◽  
Nutritional Status ◽  
Bone Mass ◽  
Older People ◽  
Muscle Mass ◽  
Community Dwelling ◽  
Risk Category ◽  
Calf Circumference ◽  
Factors Associated ◽  
Community Dwelling Older People

Abstract Objectives Malnutrition contributes to loss of muscle mass. There is limited information on the prevalence of low muscle mass in community-dwelling older people who are (not) at risk of malnutrition. Factors associated with muscle mass are also not well characterized. This cross-sectional study aimed to determine the prevalence of low appendicular skeletal muscle mass index (ASMI; ASM/height2) in older people with normal nutritional status (Malnutrition Universal Screening Tool, MUST risk category = low) and those at risk of malnutrition (MUST risk category = medium or high), and to determine factors associated with ASMI. Methods Strengthening Health In ELDerly through nutrition (SHIELD) is a study involving 1211 (400 with normal nutritional status and 811 at risk of malnutrition) community-dwelling older people aged ≥65 years in Singapore. Low ASMI was determined by bioelectrical impedance analysis (Asian Working Group for Sarcopenia, 2014). Results One in five (20.6%) nourished participants had low ASMI vs. four in five (81.3%) participants at risk of malnutrition had low ASMI (P < 0.0001). Older people with low ASMI were more likely to be admitted to the hospital, had longer length of stay, 25-hydroxyvitamin D deficiency, and lower education level, compared to those with normal ASMI (all P ≤ 0.0472). In the multiple linear regression model, age (coefficient, b = −0.013 kg/m2; P < 0.001), gender (female: b = −0.963 kg/m2; P < 0.001), calf circumference (b = 0.042 kg/m2; P < 0.001), bone mass (b = 0.593 kg/m2; P < 0.001), BMI (b = 0.129 kg/m2; P < 0.001), and Physical Activity Scale for the Elderly (PASE) score (b = 0.001 kg/m2; P = 0.048) were associated with ASMI. Conclusions Community-dwelling older people at risk of malnutrition had four-fold greater risk of having low ASMI as compared to nourished counterparts. Increasing age was associated with lower ASMI, whereas calf circumference, bone mass, BMI, PASE score, and being male were positively associated with ASMI. These findings highlight the importance of screening for low muscle mass and maintaining muscle health as part of the overall malnutrition management in this population group. Funding Sources The Economic Development Board of Singapore, Abbott Nutrition, and Changi General Hospital funded this study.

What Works Better for Community-Dwelling Older People at Risk to Fall?

2009 ◽  
Vol 21 (5) ◽  
pp. 713-729 ◽  
Author(s):  
Eleni Th. Petridou ◽  
Eirini G. Manti ◽  
Athanasios G. Ntinapogias ◽  
Eva Negri ◽  
Katarzyna Szczerbińska
Keyword(s):  
At Risk ◽  
Older People ◽  
Community Dwelling ◽  
What Works ◽  
Community Dwelling Older People

scholarly journals Exploring associations between oral health and frailty in community-dwelling older people

2020 ◽  
pp. 1-7
Author(s):  
B. Everaars ◽  
K. Jerković – Ćosić ◽  
N. Bleijenberg ◽  
N.J. de Wit ◽  
G.J.M.G. van der Heijden
Keyword(s):  
At Risk ◽  
Oral Health ◽  
Older People ◽  
Dental Care ◽  
Community Dwelling ◽  
Care Utilization ◽  
Emergency Visit ◽  
Dental Care Utilization ◽  
Community Dwelling Older People ◽  
Dental Emergency

Background: In frail older people with natural teeth factors like polypharmacy, reduced salivary flow, a decrease of oral self-care, general healthcare issues, and a decrease in dental care utilization contribute to an increased risk for oral complications. On the other hand, oral morbidity may have a negative impact on frailty. Objective: This study explored associations between oral health and two frailty measures in community-dwelling older people. Design: A cross-sectional study. Setting: The study was carried out in a Primary Healthcare Center (PHC) in The Netherlands. Participants: Of the 5,816 persons registered in the PHC, 1,814 persons were eligible for participation at the start of the study. Measurements: Two frailty measures were used: 1. Being at risk for frailty, using Electronical Medical Record (EMR) data, and: 2. Survey-based frailty using ‘The Groningen Frailty Indicator’ (GFI). For oral health measures, dental-record data (dental care utilization, dental status, and oral health information) and self-reported oral problems were recorded. Univariate regression analyses were applied to determine the association between oral health and frailty, followed by age- and sex-adjusted multivariate logistic regressions. Results: In total 1,202 community-dwelling older people were included in the study, 45% were male and the mean age was 73 years (SD=8). Of all participants, 53% was at risk for frailty (638/1,202), and 19% was frail based on the GFI (222/1,202). A dental emergency visit (Odds Ratio (OR)= 2.0, 95% Confidence Interval (CI)=1.33;3.02 and OR=1.58, 95% CI=1.00;2.49), experiencing oral problems (OR=2.07, 95% CI=1.52;2.81 and OR=2.87, 95% CI= 2.07;3.99), and making dietary adaptations (OR=2.66, 95% CI=1.31;5.41 and OR=5.49, 95% CI= 3.01;10.01) were associated with being at risk for frailty and survey-based frailty respectively. Conclusions: A dental emergency visit and self-reported oral health problems are associated with frailty irrespective of the approach to its measurement. Healthcare professionals should be aware of the associations of oral health and frailty in daily practice.

scholarly journals Review of Diagnostic Test Accuracy (DTA) studies in older people

2018 ◽  
Vol 47 (3) ◽  
pp. 349-355 ◽  
Author(s):  
Yemisi Takwoingi ◽  
Terence J Quinn
Keyword(s):  
Older People ◽  
Diagnostic Test ◽  
Diagnostic Test Accuracy ◽  
Test Accuracy ◽  
Dta Studies
Sign in / Sign up

Export Citation Format

Share Document