title: A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans.
abstract: OBJECTIVE
  To validate the FRAIL scale.
  
  
  METHODS
  Longitudinal study.
  
  
  METHODS
  Community.
  
  
  METHODS
  Representative sample of African Americans age 49 to 65 years at onset of study.
  
  
  METHODS
  The 5-item FRAIL scale (fatigue, resistance, ambulation, illnesses, and loss of weight), at baseline and activities of daily living (ADLs), instrumental activities of daily living (IADLs), mortality, short physical performance battery (SPPB), gait speed, one-leg stand, grip strength and injurious falls at baseline and 9 years. Blood tests for CRP, SIL6R, STNFR1, STNFR2 and 25 (OH) vitamin D at baseline.
  
  
  RESULTS
  Cross-sectionally the FRAIL scale correlated significantly with IADL difficulties, SPPB, grip strength and one-leg stand among participants with no baseline ADL difficulties (N=703) and those outcomes plus gait speed in those with no baseline ADL dependencies (N=883). TNFR1 was increased in pre-frail and frail subjects and CRP in some subgroups. Longitudinally (N=423 with no baseline ADL difficulties or N=528 with no baseline ADL dependencies), and adjusted for the baseline value for each outcome, being pre-frail at baseline significantly predicted future ADL difficulties, worse one-leg stand scores, and mortality in both groups, plus IADL difficulties in the dependence-excluded group. Being frail at baseline significantly predicted future ADL difficulties, IADL difficulties, and mortality in both groups, plus worse SPPB in the dependence-excluded group.
  
  
  CONCLUSIONS
  This study has validated the FRAIL scale in a late middle-aged African American population. This simple 5-question scale is an excellent screening test for clinicians to identify frail persons at risk of developing disability as well as decline in health functioning and mortality.
authors: Division of Geriatrics, Department of Internal Medicine, 1402 South Grand Boulevard, St. Louis, MO 63104, USA. morley@slu.edu
authors: J E
authors: JE
authors: Morley
authors: T K
authors: TK
authors: Malmstrom
authors: D K
authors: DK
authors: Miller
mesh_terms: D000203:Activities of Daily Living; D001741:Black or African American; D000368:Aged; D003430:Cross-Sectional Studies; D005221:Fatigue; D005260:Female; D016330:Frail Elderly; D005684:Gait; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011795:Surveys and Questionnaires; D016896:Treatment Outcome