title: Postal screening can identify frailty and predict poor outcomes in older adults: longitudinal data from INTER-FRAIL study.
abstract: identification of older individuals at risk for health-related adverse outcomes (HRAO) is necessary for population-based preventive interventions. Aim of this study was to improve a previously validated postal screening questionnaire for frailty in non-disabled older subjects and to test its prognostic validity in a vast sample of older community-dwellers.
  
  
  
  individuals aged 70+ underwent a mass postal screening. Physical frailty phenotype (PFP) was assessed in the unselected subsample of the first responders. After a 1-year follow-up, HRAO were recorded in the whole sample, including survival, access to Emergency Department, hospitalisation and Long-Term Care admission.
  
  
  
  the questionnaire was mailed to 17,273 subjects, whose response rate was 55%. Among the first 1,037 responders without overt disability, the revised questionnaire was 75% sensitive and 69% specific for PFP (ROC 0.772). Non-disabled subjects who screened positive had a higher risk of HRAO in comparison with those who screened negative and similar to non-responders. Risk of adverse outcome was highest among disabled subjects.
  
  
  
  a simple questionnaire delivered by mail has good accuracy in detecting PFP in non-disabled older subjects and is able to predict HRAO.
authors.affiliation: Research Unit of Medicine of Ageing, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Mossello
authors.affiliation: Osservatorio di Epidemiologia, Agenzia Regionale di Sanità della Toscana, Florence, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Profili
authors.affiliation: Research Unit of Medicine of Ageing, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Di Bari
authors.affiliation: Division of Geriatric Medicine, Azienda Sanitaria di Firenze, Florence, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Bandinelli
authors.affiliation: Osservatorio di Epidemiologia, Agenzia Regionale di Sanità della Toscana, Florence, Italy.
authors.forename: Matilde
authors.initials: M
authors.lastname: Razzanelli
authors.affiliation: Fiorentina Sud-Est Health District, Azienda Sanitaria di Firenze, Florence, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Salvioni
authors.affiliation: Valdichiana Senese Health District, Unità Funzionale Segretariato Sociale, Azienda USL 7, Siena, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Corridori
authors.affiliation: Directorate General for Prevention, Italian Ministry of Health, Rome, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Di Fiandra
authors.affiliation: Osservatorio di Epidemiologia, Agenzia Regionale di Sanità della Toscana, Florence, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Francesconi
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D016330:Frail Elderly; D000073496:Frailty / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D015577:Geriatric Assessment / Q000379:methods*; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008134:Long-Term Care / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening / Q000379:methods*; D010343:Patient Admission; D011177:Postal Service; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: frailty; older people; postal screening; prognosis