Use of a questionnaire to screen for frailty in the elderly: an exploratory study.
OBJECTIVE
In a pilot study of community-dwelling geriatric clinic patients (N=48, aged 63-90) we examined the use of a questionnaire to classify frailty status by comparing it with standardized markers of frailty. The questionnaire, developed by Strawbridge et al. in 1998, defines frailty as difficulty in more than one of four domains of functioning: physical, cognitive, sensory, and nutritive.


METHODS
Subjects were classified as frail or not frail by questionnaire and assignment was compared with testing of physical and cognitive measures in cross-sectional analysis. Demographic variables, functional inventories, physical activity levels, clinician impression of frailty, and 3-year health outcomes were also examined.


RESULTS
Thirty-three percent of subjects were classified as frail. Frailty classification by the Strawbridge questionnaire was correlated to Timed Up and Go and repetitive Sit-to-Stand tests, bimanual dexterity and cognitive tests. A discrepancy was found between assignment of cognitive difficulty, by questionnaire and cognitive performance. When overall Strawbridge frailty scores were modified to account for those with poor cognitive performance who did not report cognitive difficulty, the prevalence of frailty increased to 42%. At 3-year follow-up, the modified Strawbridge frailty classification (p<0.05) and clinician impression of frailty (p<0.01) were both significant predictors of death and institutionalization combined.


CONCLUSIONS
This study serves as an initial inquiry into the potential validity and utility of the Strawbridge frailty questionnaire as a simple screening tool to identify patients who may warrant detailed functional testing.
Matthews
Margaret
M
University of South Carolina School of Medicine/Division of Geriatrics, Palmetto Health Alliance, Columbia, SC 29203, USA. margaret.matthews@palmettohealth.org
Lucas
Amy
A
Boland
Rebecca
R
Hirth
Victor
V
Odenheimer
Germaine
G
Wieland
Darryl
D
Williams
Harriet
H
Eleazer
G Paul
GP
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006306:Health Surveys; D006801:Humans; D007326:Institutionalization; D008875:Middle Aged; D010865:Pilot Projects; D013223:Statistics as Topic; D011795:Surveys and Questionnaires