title: Fried frailty phenotype assessment components as applied to geriatric inpatients.
abstract: BACKGROUND
  Management of geriatric patients would be simplified if a universally accepted definition of frailty for clinical use was defined. Among definitions of frailty, Fried frailty phenotype criteria constitute a common reference frame for many geriatric studies. However, this reference frame has been tested primarily in elderly patients presenting with relatively good health status.
  
  
  OBJECTIVE
  The aim of this article was to assess the usefulness and limitations of Fried frailty phenotype criteria in geriatric inpatients, characterized by comorbidity and functional impairments, and to estimate the frailty phenotype prevalence in this group.
  
  
  METHODS
  Five hundred consecutive patients of the university hospital subacute geriatric ward, aged 79.0±8.4 years (67% women and 33% men), participated in this cross-sectional study. Comprehensive geriatric assessment and Fried frailty phenotype component evaluation were performed in all patients.
  
  
  RESULTS
  Multimorbidity (6.0±2.8 diseases) characterized our study group, with a wide range of clinical conditions and functional states (Barthel Index of Activities of Daily Living 72.2±28.2 and Mini-Mental State Examination 23.6±7.1 scores). All five Fried frailty components were assessed in 65% of patients (95% confidence interval [CI] =60.8-69.2) (diagnostic group). One or more components were not feasible to be assessed in 35% of the remaining patients (nondiagnostic group) because of lack of past patient's body mass control and/or cognitive or physical impairment. Patients from the nondiagnostic group, as compared to patients from the diagnostic group, presented with more advanced age, higher prevalence of dementia, lower prevalence of hypertension, lower systolic and diastolic blood pressure, body mass index, Mini-Mental State Examination and Barthel Index of Activities of Daily Living. Despite diagnostic limitations, we found ≥3 positive criteria (thus, frailty diagnosis) in 54.2% of the study group (95% CI =49.8-58.6), with prevalence from 31.7% in sexagenarians to 67.6% in nonagenarians.
  
  
  CONCLUSIONS
  Fried frailty phenotype criteria seem useful for geriatric inpatient assessment, despite diagnostic limitations. High prevalence of frailty among geriatric inpatients suggests that evaluation for frailty should be considered a part of the comprehensive geriatric assessment.
authors.affiliation: Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Bieniek
authors.affiliation: Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Wilczyński
authors.affiliation: Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
authors.forename: Jan
authors.initials: J
authors.lastname: Szewieczek
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D005853:Geriatrics / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients; D008297:Male; D010641:Phenotype; D011044:Poland
keywords: comprehensive geriatric assessment; frail older adults; frailty phenotype; geriatric subacute care; geriatric ward; multimorbidity