The assessment of frailty in older people in acute care.
OBJECTIVE
Develop a measure of frailty for older acute inpatients to be performed by non-geriatricians.


METHODS
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).


CONCLUSIONS
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.
Hilmer
Sarah N
SN
Department of Aged Care , Royal North Shore Hospital, St Leonards, Australia. shilmer@med.usyd.edu.au
Perera
Vidya
V
Mitchell
Sarah
S
Murnion
Bridin P
BP
Dent
Jonathan
J
Bajorek
Beata
B
Matthews
Slade
S
Rolfson
Darryl B
DB
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales