Application of the clinical frailty scale,the Fried frailty phenotype scale and the Edmonton frailty scale among the elderly in Beijing nursing homes
Objective To evaluate the effectiveness of the clinical frailty scale(CFS),the fried frailty phenotype scale(FFP),and the Edmonton frailty scale(EFS)in assessing frailty among elderly individuals residing in nursing homes.Methods Convenience sampling methods were used to enroll 167 elderly individuals aged 60 years and above from four Beijing nursing homes for this study conducted from October to December 2021.The CFS,FFP,and EFS were used for assessing frailty.The consistency and discrepancies of the assessment results were analyzed.Furthermore,the correlation between the scores of each scale and the health indicators was examined.The effectiveness of the three scales in identifying disability was evaluated using the receiver operating characteristic curve(ROC).Results The study found that the highest detection rate of frailty was 35.33％(59/167)for CFS,which was higher than the rates for FFP(23.35％,39/167)and EFS(24.55％,41/167).The statistical analysis showed significant differences between the groups(x2=9.500,P=0.002 for CFS vs.FFP;x2=7.605,P=0.005 for CFS vs.EFS).The Kappa values for the consistency of results between CFS and FFP,CFS and EFS,and FFP and EFS were 0.461,0.465 and 0.441,respectively(all P＜0.001).After adjusting for age and gender,only the CFS score showed a positive correlation with the number of chronic diseases(r=0.190,P=0.018).The CFS,FFP,and EFS scores were negatively correlated with grip strength,short physical performance battery(SPPB),and mini-mental state examination(MMSE)(all P＜0.05),and positively correlated with the 15-item geriatric depression scale(GDS-15)(P＜0.05).The correlation coefficients between CFS and FFP scores and grip strength were higher than that of EFS(-0.431 vs.-0.248,P=0.009;-0.536 vs.-0.248,P＜0.001).Additionally,the CFS and FFP scores were negatively correlated with phase angle(PhA)(r=-0.189,P=0.016;r=-0.243,P=0.002).The analysis of the ROC revealed that the area under the ROC curve(AUC)for CFS,FFP and EFS in identifying disability were 0.87,0.78 and 0.76 respectively(all P＜0.001).The AUC value of CFS was found to be higher than that of FFP(Z=2.175,P=0.030)and EFP(Z=2.585,P=0.010).Conclusions The CFS has been found to have a higher detection rate of frailty and a better ability to identify disability among the elderly residing in nursing homes.This improved detection and identification can facilitate timely interventions for frail individuals and aid in making informed healthcare decisions within nursing home settings.
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