title: Screening for Frailty With the FRAIL Scale: A Comparison With the Phenotype Criteria.
abstract: BACKGROUND
  Reliable and valid frailty screening instruments are lacking. The aim of the present study was to compare the diagnostic properties of the FRAIL-BR with Fried's frailty phenotype (CHS), which has not been done.
  
  
  METHODS
  Cross-sectional observational study of 124 older adults aged 60 or older from 2 university-based geriatric outpatient units in the state of São Paulo, Brazil. In ROC analyses, we evaluated different cutoff points and AUC areas of the FRAIL-BR compared with the CHS criteria. Also, components of both diagnostic strategies had head-to-head comparisons whenever possible.
  
  
  RESULTS
  The sample was composed mostly of overweight (mean BMI = 29.5 kg/m2) women (83%) with mean age of 78.6 (±7.1) years. Prevalence of frailty varied according to the FRAIL-BR (23.3%) and the CHS criteria (14.5%) (P = .04). A cutoff of 3 points in the FRAIL-BR presented a sensitivity of 28% and specificity of 90% (P = .049). A cutoff of 2 points resulted in a sensitivity of 54% and specificity of 73% (P = .01). Comparisons of 4 FRAIL-BR items (ie, weight loss, aerobic capacity, fatigue, and physical resistance) to the respective CHS components showed an independent diagnostic property of all measures, with the exception for weight loss.
  
  
  CONCLUSIONS
  The FRAIL scale can be used as a screening instrument for frailty (time and cost-effective).
authors.affiliation: Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, University of São Paulo (USP), São Paulo, Brazil; Institute and Department of Psychiatry, Faculty of Medicine, USP, São Paulo, Brazil; Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, Brazil. Electronic address: ivan.aprahamian@gmail.com.
authors.forename: Ivan
authors.initials: I
authors.lastname: Aprahamian
authors.affiliation: Institute and Department of Psychiatry, Faculty of Medicine, USP, São Paulo, Brazil.
authors.forename: Natália Oiring de Castro
authors.initials: NOC
authors.lastname: Cezar
authors.affiliation: Department of Statistics, Federal University of São Carlos (UFSCar), São Carlos, Brazil.
authors.forename: Rafael
authors.initials: R
authors.lastname: Izbicki
authors.affiliation: Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, University of São Paulo (USP), São Paulo, Brazil.
authors.forename: Sumika Mori
authors.initials: SM
authors.lastname: Lin
authors.affiliation: Department of Internal Medicine, Faculty of Medical Sciences, Campinas State University (Unicamp), Campinas, Brazil.
authors.forename: Débora Lee Vianna
authors.initials: DLV
authors.lastname: Paulo
authors.affiliation: Department of Internal Medicine, Faculty of Medical Sciences, Campinas State University (Unicamp), Campinas, Brazil.
authors.forename: André
authors.initials: A
authors.lastname: Fattori
authors.affiliation: Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, University of São Paulo (USP), São Paulo, Brazil.
authors.forename: Marina Maria
authors.initials: MM
authors.lastname: Biella
authors.affiliation: Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, University of São Paulo (USP), São Paulo, Brazil.
authors.forename: Wilson
authors.initials: W
authors.lastname: Jacob Filho
authors.affiliation: Department of Neurology, Faculty of Medicine, USP, São Paulo, Brazil; School of Arts, Sciences and Humanities, USP, São Paulo, Brazil.
authors.forename: Mônica Sanches
authors.initials: MS
authors.lastname: Yassuda
mesh_terms: D000368:Aged; D001938:Brazil; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000175:diagnosis; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D000073496:Frailty / Q000175:diagnosis* / Q000453:epidemiology; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D012372:ROC Curve; D012720:Severity of Illness Index
keywords: Frailty; geriatric assessment; phenotype criteria; screening