title: The SHARE frailty instrument for primary care predicts incident disability in a European population-based sample.
abstract: BACKGROUND
  The adoption of a frailty paradigm in primary care would be helpful to identify adults who need priority access to specialised resources. The frailty phenotype by Fried et al is a popular operationalisation of frailty, but it is not easily applicable in routine primary care practice. We recently created and validated a frailty instrument based on the Survey of Health, Ageing and Retirement in Europe (SHARE-FI), in order to provide primary care practitioners with an easy, reliable and freely accessible tool for the assessment and monitoring of frailty in community dwelling adults over the age of 50 years (www.biomedcentral.com/1471-2318/10/57).
  
  
  OBJECTIVE
  To provide further prospective validation of SHARE-FI, with a focus on disability.
  
  
  METHODS
  
  
  
  METHODS
  longitudinal study (wave 1: 2004-2006; mean follow-up: 2.4 years).
  
  
  METHODS
  European population-based survey (12 countries).
  
  
  METHODS
  17 567 community dwelling participants (mean age 63.3 years), of whom 13 378 (76.2%) were non-frail, 3438 (19.6%) pre-frail and 751 (4.3%) frail.
  
  
  METHODS
  number of difficulties with basic (ADL) and instrumental (IADL) activities of daily living.
  
  
  METHODS
  repeated measures ANOVA with adjustment for baseline age.
  
  
  RESULTS
  By wave 2, 3.6% of the non-frail, 12.2% of the pre-frail and 30.4% of the frail had increased their number of ADL difficulties by at least one. Likewise, 6.6% of the non-frail, 20.4% of the prefrail and 36.6% of the frail had, by wave 2, increased their number of IADL difficulties by at least one. Table 1 shows the repeated measures ANOVA suggested.
  
  
  CONCLUSIONS
  SHARE-FI may contribute to quality in primary care by offering a quick and reliable way to assess and monitor frailty in community dwelling individuals over the age of 50 and prioritize their access to resources, and it serves as a novel tool for audit and research.
authors.affiliation: Department of Medical Gerontology, Trinity Centre for Health Sciences, St James's Hospital, Dublin 8, Ireland. romeror@tcd.ie
authors.forename: Roman
authors.initials: R
authors.lastname: Romero-Ortuno
authors.forename: Diarmuid
authors.initials: D
authors.lastname: O'Shea
authors.forename: Rose Anne
authors.initials: RA
authors.lastname: Kenny
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D005060:Europe; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011446:Prospective Studies