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FRAIL-NH Predicts Outcomes in Long Term Care.
J Nutr Health Aging. 2016 Feb; 20(2):192-8.JN

Abstract

BACKGROUND/OBJECTIVES

To investigate the predictive validity of the short, simple FRAIL-NH frailty screening tool in the long term care population and to then compare the predictive validity with the frailty index (FI) for 6-month adverse health outcomes.

DESIGN

Retrospective study using the Minimum Data Set (MDS) 3.0 and chart review from June-December 2014.

SETTING

Two Long Term Care Facilities in Saint Louis, MO.

PARTICIPANTS

270 patients ages ≥ 65 years old residing in long term care.

MEASUREMENTS

Frailty was measured using the FRAIL-NH and Frailty Index (FI) criteria. Adverse outcomes measured at 6-month follow-up included falls, hospitalizations, and hospice enrollment/mortality.

RESULTS

Based on screening tool used frailty prevalence was 48.7% for FRAIL-NH and 30.3% for FI. The FRAIL-NH pre-frail (Adjusted Odds Ratio [AOR]=2.62; 95% Confidence Interval [CI]=1.25-5.54; p=0.11) classification was associated with 6 month risk of falling and mortality/hospice enrollment was associated with the frail classification, AOR=3.96 (1.44-10.87, p=0.007). Combining the pre-frail and frail categories both measures predicted 6 month mortality with the FRAIL-NH being the strongest predictor (AOR=3.36; 95%CI=1.26-8.98; p=0.016) and the FI was a more modest predictor with an AOR of 2.28; 95%CI=1.01-5.15; p=0.047. When directly comparing the FRAIL-NH to the FI, the FRAIL-NH pre-frail were at increased risk of falling, AOR=2.42 (1.11-5.92, p=0.027) and the FRAIL-NH frail were at increased risk of hospice enrollment/death, OR=3.25 (1.04- 10.86) p=0.044.

CONCLUSION

In comparison to the FI, the FRAIL-NH preformed just as well at screening for frailty and was a slightly better predictor of adverse outcomes. The FRAIL-NH is a brief, easy-to-administer frailty screening tool appropriate for long term care patients and predicts increased risk of falls in the pre-frail and mortality/hospice enrollment in the frail.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Kaehr EW
Ellen W. Kaehr, M.D. Division of Geriatrics, Department of Internal Medicine, 1402 South Grad Boulevard, St. Louis, MO 63104, email kaehrew@slu.edu, telephone 314-977-8462, fax 314-771-8575.
Pape LC
No affiliation info available
Malmstrom TK
No affiliation info available
Morley JE
No affiliation info available

MeSH

Accidental FallsActivities of Daily LivingAgedAged, 80 and overFemaleFrail ElderlyGeriatric AssessmentHealth StatusHospicesHospitalizationHumansLong-Term CareMaleMass ScreeningMissouriMortalityOdds RatioPrevalenceReproducibility of ResultsRetrospective Studies

Pub Type(s)

Journal Article
Validation Study

Language

eng

PubMed ID

26812516

Citation

Kaehr, E W., et al. "FRAIL-NH Predicts Outcomes in Long Term Care." The Journal of Nutrition, Health & Aging, vol. 20, no. 2, 2016, pp. 192-8.
Kaehr EW, Pape LC, Malmstrom TK, et al. FRAIL-NH Predicts Outcomes in Long Term Care. J Nutr Health Aging. 2016;20(2):192-8.
Kaehr, E. W., Pape, L. C., Malmstrom, T. K., & Morley, J. E. (2016). FRAIL-NH Predicts Outcomes in Long Term Care. The Journal of Nutrition, Health & Aging, 20(2), 192-8. https://doi.org/10.1007/s12603-016-0682-5
Kaehr EW, et al. FRAIL-NH Predicts Outcomes in Long Term Care. J Nutr Health Aging. 2016;20(2):192-8. PubMed PMID: 26812516.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - FRAIL-NH Predicts Outcomes in Long Term Care. AU - Kaehr,E W, AU - Pape,L C, AU - Malmstrom,T K, AU - Morley,J E, PY - 2016/1/27/entrez PY - 2016/1/27/pubmed PY - 2016/9/10/medline SP - 192 EP - 8 JF - The journal of nutrition, health & aging JO - J Nutr Health Aging VL - 20 IS - 2 N2 - BACKGROUND/OBJECTIVES: To investigate the predictive validity of the short, simple FRAIL-NH frailty screening tool in the long term care population and to then compare the predictive validity with the frailty index (FI) for 6-month adverse health outcomes. DESIGN: Retrospective study using the Minimum Data Set (MDS) 3.0 and chart review from June-December 2014. SETTING: Two Long Term Care Facilities in Saint Louis, MO. PARTICIPANTS: 270 patients ages ≥ 65 years old residing in long term care. MEASUREMENTS: Frailty was measured using the FRAIL-NH and Frailty Index (FI) criteria. Adverse outcomes measured at 6-month follow-up included falls, hospitalizations, and hospice enrollment/mortality. RESULTS: Based on screening tool used frailty prevalence was 48.7% for FRAIL-NH and 30.3% for FI. The FRAIL-NH pre-frail (Adjusted Odds Ratio [AOR]=2.62; 95% Confidence Interval [CI]=1.25-5.54; p=0.11) classification was associated with 6 month risk of falling and mortality/hospice enrollment was associated with the frail classification, AOR=3.96 (1.44-10.87, p=0.007). Combining the pre-frail and frail categories both measures predicted 6 month mortality with the FRAIL-NH being the strongest predictor (AOR=3.36; 95%CI=1.26-8.98; p=0.016) and the FI was a more modest predictor with an AOR of 2.28; 95%CI=1.01-5.15; p=0.047. When directly comparing the FRAIL-NH to the FI, the FRAIL-NH pre-frail were at increased risk of falling, AOR=2.42 (1.11-5.92, p=0.027) and the FRAIL-NH frail were at increased risk of hospice enrollment/death, OR=3.25 (1.04- 10.86) p=0.044. CONCLUSION: In comparison to the FI, the FRAIL-NH preformed just as well at screening for frailty and was a slightly better predictor of adverse outcomes. The FRAIL-NH is a brief, easy-to-administer frailty screening tool appropriate for long term care patients and predicts increased risk of falls in the pre-frail and mortality/hospice enrollment in the frail. SN - 1760-4788 UR - https://www.unboundmedicine.com/medline/citation/26812516/FRAIL_NH_Predicts_Outcomes_in_Long_Term_Care_ DB - PRIME DP - Unbound Medicine ER -