title: Feasibility and Factor Structure of the FRAIL Scale in Older Adults.
abstract: OBJECTIVE
  The aim of the present study was to (1) evaluate a geriatric outpatient sample with the FRAIL scale; (2) investigate the psychometric properties of the scale; and (3) characterize different associations of the subdimensions of the scale with demographic and clinical data.
  
  
  METHODS
  Cross-sectional observational study.
  
  
  METHODS
  Geriatric outpatient center a university-based hospital in São Paulo, Brazil.
  
  
  METHODS
  A total of 811 men and women aged 60 years or older evaluated between March 2015 and September 2015.
  
  
  METHODS
  A translated version of the FRAIL scale was used to evaluate frailty. A review of sociodemographic data, medical records, medication, and laboratory data was conducted. A multivariate ordinal logistic regression model was used to investigate the association between frailty categories and clinical variables. Exploratory factor analysis and 2-parameter logistic item response theory was used to evaluate the psychometric properties of the FRAIL scale.
  
  
  RESULTS
  The sample was distributed as 13.6% robust, 48.7% prefrail, and 37.7% frail older adults. Most participants reported fatigue (72.3%). Frailty was associated with older age (P = .02), depression (P = .02), dementia (P < .001), and number of medications taken (P < .001). A 2-factor model of the FRAIL scale ("ambulation" and "resistance" namely physical performance; "fatigue," "weight loss," and "illnesses" namely health status) provided independent classifications of frailty status. Physical performance (ambulation and resistance) was strongly associated with higher age and dementia, whereas health status (fatigue, weight loss, and illnesses) was more associated with female sex and depression.
  
  
  CONCLUSIONS
  Our results suggest the existence of 2 subdimensions of the scale, suggesting different pathways to frailty. Frailty was associated with older age, depression, dementia, and number of medications in this outpatient sample.
authors.affiliation: Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil; Institute and Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, State of São Paulo, Brazil; Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, State of São Paulo, Brazil. Electronic address: ivan.aprahamian@gmail.com.
authors.forename: Ivan
authors.initials: I
authors.lastname: Aprahamian
authors.affiliation: Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Sumika Mori
authors.initials: SM
authors.lastname: Lin
authors.affiliation: Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Claudia Kimie
authors.initials: CK
authors.lastname: Suemoto
authors.affiliation: Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Daniel
authors.initials: D
authors.lastname: Apolinario
authors.affiliation: Institute and Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, State of São Paulo, Brazil.
authors.forename: Natália
authors.initials: N
authors.lastname: Oiring de Castro Cezar
authors.affiliation: Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Serpui Marie
authors.initials: SM
authors.lastname: Elmadjian
authors.affiliation: Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Wilson Jacob
authors.initials: WJ
authors.lastname: Filho
authors.affiliation: Department of Neurology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil.
authors.forename: Mônica Sanches
authors.initials: MS
authors.lastname: Yassuda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D016330:Frail Elderly; D000073496:Frailty / Q000175:diagnosis*; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D011795:Surveys and Questionnaires
keywords: Frailty; geriatric assessment; multimorbidities; physical performance