Can proxy assessments serve as a first screener for identifying people at risk for multidimensional frailty?

D-Scope Consortium ,Anne Van Der Vorst,Jan De Lepeleire,Nico De Witte,G A Rixt Zijlstra,Jos M G A Schols,Gertrudis I J M Kempen

doi:10.1007/s41999-018-0067-x

D-Scope Consortium , Anne Van Der Vorst + Show 5 more

Open Access

https://doi.org/10.1007/s41999-018-0067-x

Copy DOI

Abstract

PurposeTimely detection of multidimensional frailty is important to prevent further negative outcomes. Perspectives of general practitioners (GPs) or informal caregivers might serve as a first, global screener to identify older people in need of a more extended assessment. Therefore, we aimed to investigate whether proxy assessments are associated with older people’s self-reported environmental, physical, psychological, social and overall frailty.MethodsA cross-sectional study was conducted on 78 community-dwelling people aged 60 years and over, their GPs (n = 57) and informal caregivers (n = 50). Self-reported frailty was assessed with the Comprehensive Frailty Assessment Instrument. GPs and informal caregivers rated each frailty domain and overall frailty on a scale of 0 (not frail at all) to 10 (severely frail). Associations between proxy scores and self-reported frailty were examined by correlation analyses.ResultsSignificant low to moderate associations were found between (1) self-reported physical frailty and physical frailty scores given by the GPs (r = 0.366, p ≤ 0.01) and informal caregivers (r = 0.305, p ≤ 0.05), and (2) self-reported psychological frailty and psychological frailty scores given by the GPs (r = 0.230, p ≤ 0.05) and informal caregivers (r = 0.254, p ≤ 0.05). No significant associations were found between proxy scores and self-reported environmental, social and overall frailty.ConclusionsGlobal proxy scores as short, subjective screeners for detecting frailty cannot completely replace self-reported frailty. Nonetheless, low to moderate correlations were found for physical and psychological frailty ratings, suggesting that proxy scores might be of value as a first sign of something being wrong for these domains.

Highlights

Frailty is often seen as merely a physical construct [1], it can be regarded as a multidimensional phenomenon that includes experiencing losses in physical, 1 Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O
Afterwards, participants were asked whether their general practitioners (GPs) and/or informal caregiver could be invited for a proxy interview
For 62 older people no informal caregivers were interviewed because 33 respondents did not have an informal caregiver (27.3%), 17 refused a proxy assessment by their informal caregiver (14.0%), 9 informal caregivers could not be reached during the study period (7.4%) and 3 refused to participate (2.5%)

Summary

Introduction

Frailty is often seen as merely a physical construct [1], it can be regarded as a multidimensional phenomenon that includes experiencing losses in physical,1 3 Vol.:(0123456789)European Geriatric Medicine (2018) 9:501–507 psychological, social, and environmental aspects [2]. Recent studies have shown that multidimensional frailty is associated with higher age [4], amongst other factors, and may lead to negative consequences such as disability and increased health care utilisation [5]. Frailty might jeopardise the wish of older people to ‘age in place’ [6]. This is important from a policy perspective, for example, in terms of reducing the costs of long-term care [7]. In view of the larger proportion of older people in society today [8], and the possible negative consequences [5], timely detection of frailty is important for prevention strategies to reduce the risk of negative outcomes

Objectives

Methods

Results

Discussion

Conclusion