title: Frailty assessment in the geriatric outpatient clinic.
abstract: OBJECTIVE
  Frailty is a common phenomenon in geriatric patients. In the present translational research study, we assessed two frailty instruments (Fried 2001; Gill 2002), comparing the usefulness and scoring classifications for frailty screening in an academically affiliated geriatrics clinic.
  
  
  METHODS
  Assessment was completed on 162 male veterans (mean age 83.7 years, 57% African American) enrolled in a geriatric clinic. The instruments' component criteria, which are well known to gerontological clinicians, were administered in a standard order and scoring was identical to original instruments.
  
  
  RESULTS
  The five-item Fried frailty instrument required 15-20 min to complete; the two-item Gill frailty instrument required less than 2 min. Of the 162 participants assessed, 72 were determined to be frail by at least one of the instruments, but just 33 were frail by both instruments. Correlations between the instruments were Spearman = 0.55 (P < 0.001) and kappa = 0.25, (P < 0.001). There were no differences in frailty scores based on race, and there were equivocal results based on age, even though this was an older sample, with almost 17% ≥90 years. A total of 63% (103/162) of the sample met the criterion for weak grip strength, and decreasing grip strength correlated with increasing age (r = -0.238, P = 0.002).
  
  
  CONCLUSIONS
  Expedient identification of the frailty syndrome remains an unmet necessity for clinical practice. The different results by the Fried and Gill frailty instruments are likely due to differences in component domains and testing methods. The present results support previous findings that showed that grip strength might be an important indicator of increasing frailty.
authors.affiliation: School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: Hidong
authors.initials: H
authors.lastname: Kim
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Higgins
authors.forename: David H
authors.initials: DH
authors.lastname: Canaday
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Burant
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Hornick
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D018434:Sickness Impact Profile; D014481:United States
keywords: clinical medicine; frailty; function; geriatric medicine