title: Preinjury Physical Function and Frailty in Injured Older Adults: Self- Versus Proxy Responses.
abstract: OBJECTIVE
  To determine the extent to which proxy respondents can provide reliable reports.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Level I trauma center.
  
  
  METHODS
  Seventy-seven older adults (≥65, median 73.0, interquartile range 67-80; 53% female) admitted to three services (trauma, geriatrics, orthopedics) with primary injury diagnoses over a 6-month period and their proxies (43% spouses, 44% children, 5% siblings, 8% friends or other relatives).
  
  
  METHODS
  Three brief screening instruments (Vulnerable Elders Survey-13 (VES-13), modified Barthel Index (mBI), Life Space Assessment (LSA)) for physical function and frailty were administered to older adults and their proxies within 48 hours of admission. Data analysis included frequencies, percentages, intraclass correlations, and Kappa statistics.
  
  
  RESULTS
  Approximately 47% (n = 36) of the proxies lived with the older adults. Perfect agreement and 90% agreement between older adults and proxies: There was perfect agreement for 39 (51%) dyads and a difference of 1 or less (range 1-10) for 66 (86%) on the VES-13, perfect agreement for 48 (62%) and a difference of two or less (range 0-20) for 69 (89%) on the mBI, and perfect agreement for 27 (35%) and a difference of 12 or less (range 0-120) for 55 (71%) on the LSA.
  
  
  CONCLUSIONS
  Proxy reports of older adults' preinjury physical function and frailty are in an acceptable range of agreement with those of the older adults. Using proxy reports when people cannot provide information on themselves may facilitate care management and goal setting.
authors.affiliation: School of Nursing, Vanderbilt University, Nashville, Tennessee.
authors.forename: Cathy A
authors.initials: CA
authors.lastname: Maxwell
authors.affiliation: Department of Biostatistics, School of Medicine, Nashville, Tennessee.
authors.forename: Mary S
authors.initials: MS
authors.lastname: Dietrich
authors.affiliation: School of Nursing, Vanderbilt University, Nashville, Tennessee.
authors.forename: Ann F
authors.initials: AF
authors.lastname: Minnick
authors.affiliation: School of Nursing, Vanderbilt University, Nashville, Tennessee.
authors.forename: Lorraine C
authors.initials: LC
authors.lastname: Mion
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D011446:Prospective Studies; D019727:Proxy; D057566:Self Report; D011795:Surveys and Questionnaires; D014193:Trauma Centers; D035862:Vulnerable Populations; D014947:Wounds and Injuries / Q000503:physiopathology*
keywords: injured older adults; physical frailty; self- and proxy responses