title: Simple self-report FRAIL scale might be more closely associated with dialysis complications than other frailty screening instruments in rural chronic dialysis patients.
abstract: OBJECTIVE
  Despite the perceived importance of frailty, few studies focus on its impact on rural patients undergoing chronic dialysis. Comparison of different self-report questionnaires in assessing frailty among these patients has not been attempted before.
  
  
  METHODS
  A prospectively enrolled chronic dialysis cohort from a rural centre was recruited for analysis. Six types of self-report questionnaires were administered to these patients. Clinical and dialysis-related laboratory parameters were collected. Correlation analyses between questionnaire results and dialysis complications were performed, and variables demonstrating significant correlations were entered into multivariate regression models to determine their independent associations.
  
  
  RESULTS
  Six types of questionnaire (Strawbridge questionnaire, Edmonton Frail Scale, simple FRAIL scale, Groningen Frail Indicator, G8 questionnaire, and Tilburg Frail Indicator) were provided to rural patients undergoing chronic dialysis. Scores from each questionnaire showed significant association with each other, except the G8 questionnaire. Scores from the simple FRAIL scale correlated significantly with age (P = 0.02), female gender (P = 0.03), higher Liu's comorbidity index (P = 0.02), lower serum albumin (P = 0.03) and creatinine levels (P < 0.01), and higher ferritin levels (P = 0.02). The other five questionnaires did not show consistently significant relationships with important dialysis-related complications. Multivariate linear regression analysis identified an independently negative association between serum albumin and the simple FRAIL scale results (P = 0.01).
  
  
  CONCLUSIONS
  This is the first study establishing the utility of different self-report questionnaires for assessing frailty in chronic dialysis patients. The simple FRAIL scale scores might demonstrate a closer relationship with dialysis-related complications.
authors.affiliation: Department of Medicine, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan; Division of Nephrology, Department of Internal Medicine, Taipei, Taiwan.
authors.forename: Chia-Ter
authors.initials: CT
authors.lastname: Chao
authors.forename: Yuan-Hsin
authors.initials: YH
authors.lastname: Hsu
authors.forename: Pei-Yu
authors.initials: PY
authors.lastname: Chang
authors.forename: Yu-Ting
authors.initials: YT
authors.lastname: He
authors.forename: Ruey-Shiuan
authors.initials: RS
authors.lastname: Ueng
authors.forename: Chun-Fu
authors.initials: CF
authors.lastname: Lai
authors.forename: Chih-Kang
authors.initials: CK
authors.lastname: Chiang
authors.forename: Jenq-Wen
authors.initials: JW
authors.lastname: Huang
authors.forename: Sheng-Jen
authors.initials: SJ
authors.lastname: Huang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D019035:Rural Health Services; D057566:Self Report; D012680:Sensitivity and Specificity; D012959:Socioeconomic Factors
keywords: dialysis; end-stage renal disease; frailty; haemodialysis; hypoalbuminaemia; rural