title: Performance of Edmonton Frail Scale on frailty assessment: its association with multi-dimensional geriatric conditions assessed with specific screening tools.
abstract: BACKGROUND
  The aim of this study was to evaluate the performance of Edmonton Frail Scale (EFS) on frailty assessment in association with multi-dimensional conditions assessed with specific screening tools and to explore the prevalence of frailty by gender.
  
  
  METHODS
  We enrolled 366 hospitalised patients (women\men: 251\115), mean age 81.5 years. The EFS was given to the patients to evaluate their frailty. Then we collected data concerning cognitive status through Mini-Mental State Examination (MMSE), health status (evaluated with the number of diseases), functional independence (Barthel Index and Activities Daily Living; BI, ADL, IADL), use of drugs (counting of drugs taken every day), Mini Nutritional Assessment (MNA), Geriatric Depression Scale (GDS), Skeletal Muscle Index of sarcopenia (SMI), osteoporosis and functionality (Handgrip strength).
  
  
  RESULTS
  According with the EFS, the 19.7% of subjects were classified as non frail, 66.4% as apparently vulnerable and 13.9% with severe frailty. The EFS scores were associated with cognition (MMSE: β = 0.980; p < 0.01), functional independence (ADL: β = -0.512; p < 0.00); (IADL: β = -0.338; p < 0.01); use of medications (β = 0.110; p < 0.01); nutrition (MNA: β = -0.413; p < 0.01); mood (GDS: β = -0.324; p < 0.01); functional performance (Handgrip: β = -0.114, p < 0.01) (BI: β = -0.037; p < 0.01), but not with number of comorbidities (β = 0.108; p = 0.052). In osteoporotic patients versus not-osteoporotic patients the mean EFS score did not differ between groups (women: p = 0.365; men: p = 0.088), whereas in Sarcopenic versus not-Sarcopenic patients, there was a significant differences in women: p < 0.05.
  
  
  CONCLUSIONS
  This study suggests that measuring frailty with EFS is helpful and performance tool for stratifying the state of fragility in a group of institutionalized elderly. As matter of facts the EFS has been shown to be associated with several geriatric conditions such independence, drugs assumption, mood, mental, functional and nutritional status.
authors.affiliation: Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition and Dietetics, University of Pavia, Azienda di Servizi alla Persona di Pavia, Via Emilia 12, Pavia, Italy. simoneperna@hotmail.it.
authors.forename: Simone
authors.identifier: http://orcid.org/0000-0002-2720-1473
authors.initials: S
authors.lastname: Perna
authors.affiliation: Deprtment of Internal Medicine and Medical Therapy, Section of Geriatrics University of Pavia, Azienda di Servizi alla Persona, Pavia, Italy.
authors.forename: Matthew D'Arcy
authors.initials: MD
authors.lastname: Francis
authors.affiliation: Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition and Dietetics, University of Pavia, Azienda di Servizi alla Persona di Pavia, Via Emilia 12, Pavia, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Bologna
authors.affiliation: Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition and Dietetics, University of Pavia, Azienda di Servizi alla Persona di Pavia, Via Emilia 12, Pavia, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Moncaglieri
authors.affiliation: Research and Development Unit, Indena, Milan, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Riva
authors.affiliation: Research and Development Unit, Indena, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Morazzoni
authors.affiliation: Research and Development Unit, Indena, Milan, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Allegrini
authors.affiliation: Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition and Dietetics, University of Pavia, Azienda di Servizi alla Persona di Pavia, Via Emilia 12, Pavia, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Isu
authors.affiliation: Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition and Dietetics, University of Pavia, Azienda di Servizi alla Persona di Pavia, Via Emilia 12, Pavia, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Vigo
authors.affiliation: Deprtment of Internal Medicine and Medical Therapy, Section of Geriatrics University of Pavia, Azienda di Servizi alla Persona, Pavia, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Guerriero
authors.affiliation: Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition and Dietetics, University of Pavia, Azienda di Servizi alla Persona di Pavia, Via Emilia 12, Pavia, Italy.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Rondanelli
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology*; D003071:Cognition; D015897:Comorbidity; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment / Q000379:methods*; D006305:Health Status Indicators; D006801:Humans; D007558:Italy; D008297:Male; D009752:Nutritional Status; D015995:Prevalence
keywords: Edmonton frail scale; Frailty; Functional status; Geriatric assessment; Nutrition