Heterogeneity amongst different diagnostic tools in frailty screening

Abstract

Frailty means a state of vulnerability with a predisposition to adverse health outcomes, closely related to age and a consequent loss of functional capability. Early detection is important for initiating measures to slow its progression. Primary Health Care (PHC) occupies a privileged place in this. However, we do not possess a gold standard tool for its detection. Our aim is to analyse the prevalence of frailty in PHC and define the most useful diagnostic tool for this area. Cross-sectional study with 225 people were selected from a population of 4,252 people aged over 75 years-old, from three different basic health zones of Navarre. Four different diagnostic tests for frailty were conducted: the Fried phenotype, the Short Physical Performance Battery (SPPB), the Timed Up-to-Go test (TUG) and the Gait Speed test (GS). Patients who were unable to finish any of the tests weren't included in the subsequent analysis. Fifty-one percent of participants were men, with mean age 80.5 years-old, 80% were taking more than five daily drugs, 8.4% had cognitive impairment, and 31.1 and 41.3% were independent for basic and instrumental activities, respectively, of daily living. The frailty prevalence was 8.3% for Fried phenotype, 13.7% for SPPB, 46.2% for TUG and 52.2% for Gait Speed. Great heterogeneity in the prevalence of frailty was shown depending on the tool employed. As a reliable, fast and simple tool for early detection of frailty is needed in PHC, based on our results and the particularities of PHC, we propose TUG or GS as good early predictors of this decline.