Abstract

BackgroundEarly identification of frailty is important for proactive primary care. Currently, however, there is no consensus on which measure to use. Therefore, we examined whether a Frailty Index (FI), based on ICPC-coded primary care data, and the Groningen Frailty Indicator (GFI) questionnaire identify the same older people as frail.MethodsWe conducted a cross-sectional, observational study of 1,580 patients aged ≥ 60 years in a Dutch primary care center. Patients received a GFI questionnaire and were surveyed on their baseline characteristics. Frailty-screening software calculated their FI score. The GFI and FI scores were compared as continuous and dichotomised measures.ResultsFI data were available for 1549 patients (98%). 663 patients (42%) returned their GFI questionnaire. Complete GFI and FI scores were available for 638 patients (40.4%), mean age 73.4 years, 52.8% female. There was a positive correlation between the GFI and the FI (Pearson’s correlation coefficient 0.544). Using dichotomised scores, 84.3% of patients with a low FI score also had a low GFI score. In patients with a high FI score, 55.1% also had a high GFI score. A continuous FI score accurately predicted a dichotomised GFI score (AUC 0.78, 95% CI 0.74 to 0.82). Being widowed or divorced was an independent predictor of both a high GFI score in patients with a low FI score, and a high FI score in patients with a low GFI score.ConclusionsThe FI and the GFI moderately overlap in identifying frailty in community-dwelling older patients. To provide optimal proactive primary care, we suggest an initial FI screening in routine healthcare data, followed by a GFI questionnaire for patients with a high FI score or otherwise at high risk as the preferred two-step frailty screening process in primary care.

Highlights

  • Identification of frailty is important for proactive primary care

  • Frailty index We used an Frailty Index (FI) that we developed in a previous FI validation study in the same primary care center [18]

  • Key baseline characteristics were determined for these four groups, and differences were examined between the two discrepant groups

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Summary

Introduction

Identification of frailty is important for proactive primary care. Currently, there is no consensus on which measure to use. We examined whether a Frailty Index (FI), based on ICPC-coded primary care data, and the Groningen Frailty Indicator (GFI) questionnaire identify the same older people as frail. One way of assessing frailty in the primary care setting is with a Frailty Index (FI), which uses readily available indicate higher frailty levels and an increased need for integrated care [12]. Both the FI and the GFI are feasible for use in primary care. The aim of this study is to assess if, in community-dwelling older adults, an FI based on ICPCand ATC-coded routine primary care data and the GFI will identify the same older patients as frail [14,15]

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