title: Screening for Frailty and Sarcopenia Among Older Persons in Medical Outpatient Clinics and its Associations With Healthcare Burden.
abstract: OBJECTIVE
  With an aging population and increase in multimorbidity, the importance of screening for frailty and sarcopenia has become a public health priority. Several tools to do so exist. This study aimed to examine whether the SARC-F and Edmonton frail screening tools are useful in clinical practice to identify at-risk patients for negative health outcomes who would benefit from intervention.
  
  
  METHODS
  This is a cross-sectional study of patients attending medical specialist outpatient clinics at the National University Hospital, Singapore from May 2015 to February 2016.
  
  
  METHODS
  Frailty and sarcopenia were identified using the Edmonton Frail Scale and SARC-F questionnaires, respectively. Other clinically relevant data including basic demographics, presence of caregiver, number of follow-ups, medications and hospital readmissions in the past 1 year, Charlson comorbidity index, and modified Barthel index were collected from chart review.
  
  
  RESULTS
  A total of 115 patients 65 years old and older were screened. Of the sample, 44.3% (n = 51) of patients were sarcopenic, whereas 27.0% (n = 31) were classified as frail; 23.5% (n = 27) were both frail and sarcopenic; and 87.1% of frail patients were sarcopenic, whereas 47.1% of sarcopenic patients were frail. Sarcopenia and frailty were associated with a higher Charlson comorbidity index, higher likelihood of requiring a caregiver, more medical specialty follow-ups, polypharmacy, more than 2 hospital admissions within a year, a higher number of falls and falls with serious consequences. This affected their perceived health status with 50.0% of robust patients rating their health excellent compared with 19.6% of sarcopenic patients (P < .001), 9.7% of frail patients (P < .001) and sarcopenic and frail patients scoring the lowest with 3.7% (P < .001).
  
  
  CONCLUSIONS
  The prevalence of frailty and sarcopenia among older adults attending medical outpatient clinic is high. Both syndromes are predictors of recurrent hospital admissions, polypharmacy, multiple medical clinic appointments, higher rate of falls, and falls with serious consequences. Early identification of older adults at risk of adverse health outcomes would aid in instituting timely intervention to reduce healthcare burden and improve quality of life.
authors.affiliation: Division of Geriatric Medicine, National University Hospital, Singapore. Electronic address: li_feng_tan@nuhs.edu.sg.
authors.forename: Li Feng
authors.initials: LF
authors.lastname: Tan
authors.affiliation: Department of Medicine, National University Hospital, Singapore.
authors.forename: Zhen Yu
authors.initials: ZY
authors.lastname: Lim
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Rachel
authors.initials: R
authors.lastname: Choe
authors.affiliation: Division of Geriatric Medicine, National University Hospital, Singapore.
authors.forename: Santhosh
authors.initials: S
authors.lastname: Seetharaman
authors.affiliation: Division of Geriatric Medicine, National University Hospital, Singapore.
authors.forename: Reshma
authors.initials: R
authors.lastname: Merchant
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D000073496:Frailty / Q000175:diagnosis* / Q000453:epidemiology; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008297:Male; D015995:Prevalence; D018570:Risk Assessment; D055948:Sarcopenia / Q000175:diagnosis* / Q000453:epidemiology; D012846:Singapore
keywords: Edmonton Frail Scale; SARC-F; Sarcopenia; frailty