Accuracy of functional tests to identify frail community elderly

Natália Camargo Rodrigues Iosimuta,Júlia Guimarães Reis Da Costa,Daniela Cristina Carvalho De Abreu

doi:10.33448/rsd-v11i3.26766

Natália Camargo Rodrigues Iosimuta, Júlia Guimarães Reis Da Costa + Show 1 more

Open Access

https://doi.org/10.33448/rsd-v11i3.26766

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Abstract

Objective: To verify the accuracy of functional tests in identifying frail older adults in two different regions. Methods: Observational, descriptive and cross-sectional study with the participation of 120 community older adults. Fried Phenotype and Edmonton Frail Scale were used to classify the frailty and the Timed Up and Go (TUG) and gait speed tests to identify the frail older adults. Results: In Ribeirão Preto and Lagarto, frail older adults performed TUG test in a longer time than pre-frail (p = 0.001) and non-frail (p < 0.001). As for gait speed, frail older adults had lower speed than non-frail (p = 0.01). The TUG test had moderate accuracy for the identification of frail older adults in Ribeirão Preto (AUC = 0.86, 95% CI 0.78 to 0.95, p < 0.001) and in Lagarto (AUC = 0.76, 95% CI 0.64 to 0.88, p = 0.001). Gait speed, on the other hand, is not accurate to discriminate frail older adults. The cut-off points for TUG with the highest sensitivity and specificity were 11.5 seconds for both older adults living in Ribeirão Preto and Lagarto. Conclusion: The TUG was capable of identifying frail older adults of two different regions, even when two different diagnostic methods of frailty were applied, standing out as a simple screening to be used in clinical practice.

Highlights

The accelerated growth of the aging population in Brazil is notorious, but the same does not happen with public health policies aimed at the older adults (Brasil, 2015)
The results show that an increase in the time needed to perform the Timed Up and Go (TUG) test by 0.53 seconds led to a 1.7-fold increase in the risk of older adults to be frail in Ribeirão Preto; an increase in the time needed to perform the TUG test by 0.41 seconds led to a 1.5-fold increase in the risk of older adults to be frail in Lagarto (Table 2)
The Receiver Operating Characteristics (ROC) curves showed that the TUG test (AUC = 0.86, 95% CI, 0.78-0.95, p < 0.001) has moderate accuracy for the identification of frail older adults in Ribeirão Preto

Summary

Introduction

The accelerated growth of the aging population in Brazil is notorious, but the same does not happen with public health policies aimed at the older adults (Brasil, 2015). On the contrary, there is concern with the costeffectiveness In this perspective, frail older adults are cited as a population group that needs greater attention from health care, due to the various negative outcomes associated with frailty (Boch et al, 2016, Sirven et al, 2017, Comans et al, 2016, TelloRodríguez et al, 2016). In Brazil, there is a great variation in data regarding the prevalence of frailty, with values between 6.7 and 74.1% These variations were attributed to different instruments used for classification and research scenarios (Lourenço et al, 2018). In an attempt to identify simple instruments that can be used in clinical practice in the fields of primary care, the study aims to verify the accuracy of functional tests, named Timed Up and Go and gait speed, in identifying frail older adults in two regions with different sociodemographic characteristics and using different diagnoses of frailty

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