Assessing Frailty in the General Medical Clinic of a Tertiary Hospital in Northern Malaysia: The FRAIL Scale or the Clinical Frailty Scale.

Alan Swee Hock Ch’ng,Chin Yik Ooi,Deik Roy Chuan,Chiann Ni Thiam,Irene Looi,Yong-Fang Kuo,Yin Kar Seah

doi:10.1155/2021/7570592

Alan Swee Hock Ch’ng, Chin Yik Ooi

Open Access

https://doi.org/10.1155/2021/7570592

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Abstract

Background Frailty potentially influences clinicians' decision making on treatment provided they can select the appropriate assessment tools. This study aims to investigate the difference between the FRAIL scale and the Clinical Frailty Scale (CFS) in assessing frailty among community-dwelling older adults attending the General Medical Clinic (GMC) in Seberang Jaya Hospital, Penang, Malaysia. Methods The medical records of 95 older patients (age ≥ 65) who attended the GMC from 16 December 2019 to 10 January 2020 were reviewed. Frailty was identified using the FRAIL scale and the CFS. Patient characteristics were investigated for their association with frailty and their difference in the prevalence of frailty by the FRAIL scale and CFS. Results The CFS identified nonsignificant higher prevalence of frailty compared to the FRAIL scale (21/95; 22.1% vs. 17/95; 17.9%, ratio of prevalence = 1.235, p=0.481). Minimal agreement was found between the FRAIL scale and the CFS (Kappa = 0.272, p < 0.001). Three out of 5 components of the FRAIL scale (resistance, ambulation, and loss of weight) were associated with frailty by the CFS. Higher prevalence of frailty was identified by the CFS in those above 70 years of age. The FRAIL scale identified more patients with frailty in ischaemic heart disease patients. Conclusion Patient characteristics influenced the choice of the frailty assessment tool. The FRAIL scale and the CFS may complement each other in providing optimized care to older patients who attended the GMC.

Highlights

Frailty has been an emerging concept that elucidates the health concern of heterogeneous older adults
Seberang Jaya Hospital is a government specialist hospital located in Perai, mainland Penang, Northern Malaysia, serving a local catchment area of 800,000 people. e General Medical Clinic (GMC) in Seberang Jaya Hospital which is led by internal medicine specialists runs twice a week
Comprehensive Geriatric Assessment (CGA) provided information on the presence of sensory deprivations such as vision or hearing impairment, hospitalisations or falls in the previous year, weight loss, urinary incontinence, self-reported physical fitness and health, social support, and mood. e Lawton Instrumental Activities of Daily Living (IADL) Scale which is usually incorporated into CGA, evaluates patients’ ability to perform the following: to use telephone, to shop, to prepare food, to do housekeeping, to do laundry, to travel independently or by public transport, to be responsible for their own medication, and to handle finance [17]

Summary

Introduction

Frailty has been an emerging concept that elucidates the health concern of heterogeneous older adults. It is a state of increased vulnerability to adverse outcomes contributed by cumulative declines across multiple physiological systems [1]. Is study aims to investigate the difference between the FRAIL scale and the Clinical Frailty Scale (CFS) in assessing frailty among community-dwelling older adults attending the General Medical Clinic (GMC) in Seberang Jaya Hospital, Penang, Malaysia. Frailty was identified using the FRAIL scale and the CFS. Patient characteristics were investigated for their association with frailty and their difference in the prevalence of frailty by the FRAIL scale and CFS. Minimal agreement was found between the FRAIL scale and the CFS (Kappa 0.272, p < 0.001)

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