The Korean journal of internal medicine

  • 제31권3호
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  • Pages.594-600
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  • 2016
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  • 1226-3303(pISSN)
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  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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The Korean version of the FRAIL scale: clinical feasibility and validity of assessing the frailty status of Korean elderly

  • Jung, Hee-Won (Geriatric Center, Seoul National University Bundang Hospital) ;
  • Yoo, Hyun-Jung (Geriatric Center, Seoul National University Bundang Hospital) ;
  • Park, Si-Young (Geriatric Center, Seoul National University Bundang Hospital) ;
  • Kim, Sun-Wook (Geriatric Center, Seoul National University Bundang Hospital) ;
  • Choi, Jung-Yeon (Geriatric Center, Seoul National University Bundang Hospital) ;
  • Yoon, Sol-Ji (Geriatric Center, Seoul National University Bundang Hospital) ;
  • Kim, Cheol-Ho (Geriatric Center, Seoul National University Bundang Hospital) ;
  • Kim, Kwang-il (Geriatric Center, Seoul National University Bundang Hospital)
  • 투고 : 2014.10.30
  • 심사 : 2015.01.06
  • 발행 : 2016.05.01
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: The fatigue, resistance, ambulation, illnesses, and loss of weight (FRAIL) scale is a screening tool for frailty status using a simple 5-item questionnaire. The aim of this study was to evaluate the clinical feasibility and validity of the Korean version of the FRAIL (K-FRAIL) scale. Methods: Questionnaire items were translated and administered to 103 patients aged ${\geq}65years$ who underwent a comprehensive geriatric assessment at the Seoul National University Bundang Hospital. In this cross-sectional study, the K-FRAIL scale was compared with the domains and the multidimensional frailty index of the comprehensive geriatric assessment. We also assessed the time required to complete the scale. Results: The participants' mean age was 76.8 years (standard deviation [SD], 6.1), and 55 (53.4%) were males. The mean overall frailty index was 0.19 (SD, 0.17). For K-FRAIL-robust, prefrail, and frail patients, the mean frailty indices were 0.09, 0.18, and 0.34, respectively (p for trend < 0.001). A higher degree of impairment in the K-FRAIL scale was associated with worse nutritional status, poor physical performance, functional dependence, and polypharmacy. The number of items with impairment in the K-FRAIL scale was positively associated with the frailty index (B = 3.73, p < 0.001). The K-FRAIL scale could differentiate vulnerability from robustness with a sensitivity of 0.90 and a specificity of 0.33. Of all patients, 75 (72.8%) completed the K-FRAIL scale within < 3 minutes. Conclusions: The K-FRAIL scale is correlated with the frailty index and is a simple tool to screen for frailty in a clinical setting.

키워드

과제정보

연구 과제번호 : 글로벌박사펠로우십사업

연구 과제 주관 기관 : 한국과학기술원

참고문헌

  1. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56:M146-M156. https://doi.org/10.1093/gerona/56.3.M146
  2. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet 2013;381:752-762. https://doi.org/10.1016/S0140-6736(12)62167-9
  3. Jung HW, Kim SW, Ahn S, et al. Prevalence and outcomes of frailty in Korean elderly population: comparisons of a multidimensional frailty index with two phenotype models. PLoS One 2014;9:e87958. https://doi.org/10.1371/journal.pone.0087958
  4. Extermann M, Hurria A. Comprehensive geriatric assessment for older patients with cancer. J Clin Oncol 2007;25:1824-1831. https://doi.org/10.1200/JCO.2007.10.6559
  5. Kim SW, Han HS, Jung HW, et al. Multidimensional frailty score for the prediction of postoperative mortality risk. JAMA Surg 2014;149:633-640. https://doi.org/10.1001/jamasurg.2014.241
  6. American Diabetes Association. Standards of medical care in diabetes: 2014. Diabetes Care 2014;37 Suppl 1:S14-S80. https://doi.org/10.2337/dc14-S014
  7. Stortecky S, Schoenenberger AW, Moser A, et al. Evaluation of multidimensional geriatric assessment as a predictor of mortality and cardiovascular events after transcatheter aortic valve implantation. JACC Cardiovasc Interv 2012;5:489-496. https://doi.org/10.1016/j.jcin.2012.02.012
  8. Peel NM, Kuys SS, Klein K. Gait speed as a measure in geriatric assessment in clinical settings: a systematic review. J Gerontol A Biol Sci Med Sci 2013;68:39-46. https://doi.org/10.1093/gerona/gls174
  9. Studenski S, Perera S, Patel K, et al. Gait speed and surviv-al in older adults. JAMA 2011;305:50-58. https://doi.org/10.1001/jama.2010.1923
  10. Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005;173:489-495. https://doi.org/10.1503/cmaj.050051
  11. Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging 2012;16:601-608. https://doi.org/10.1007/s12603-012-0084-2
  12. Woo J, Leung J, Morley JE. Comparison of frailty indicators based on clinical phenotype and the multiple deficit approach in predicting mortality and physical limitation. J Am Geriatr Soc 2012;60:1478-1486. https://doi.org/10.1111/j.1532-5415.2012.04074.x
  13. Malmstrom TK, Miller DK, Morley JE. A comparison of four frailty models. J Am Geriatr Soc 2014;62:721-726. https://doi.org/10.1111/jgs.12735
  14. Mahoney FI, Barthel DW. Functional evaluation: the barthel index. Md State Med J 1965;14:61-65.
  15. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9:179-186. https://doi.org/10.1093/geront/9.3_Part_1.179
  16. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987;40:373-383. https://doi.org/10.1016/0021-9681(87)90171-8
  17. Burke WJ, Roccaforte WH, Wengel SP. The short form of the Geriatric Depression Scale: a comparison with the 30-item form. J Geriatr Psychiatry Neurol 1991;4:173-178. https://doi.org/10.1177/089198879100400310
  18. Kang Y, Na DL, Hahn S. A validity study on the Korean Mini-Mental State Examination (K-MMSE) in dementia patients. J Korean Neurol Assoc 1997;15:300-308.
  19. Vellas B, Guigoz Y, Garry PJ, et al. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition 1999;15:116-122. https://doi.org/10.1016/S0899-9007(98)00171-3
  20. Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39:142-148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  21. Ensrud KE, Ewing SK, Taylor BC, et al. Comparison of 2 frailty indexes for prediction of falls, disability, fractures, and death in older women. Arch Intern Med 2008;168:382-389. https://doi.org/10.1001/archinternmed.2007.113
  22. Rockwood K, Mitnitski A. Frailty defined by deficit accumulation and geriatric medicine defined by frailty. Clin Geriatr Med 2011;27:17-26. https://doi.org/10.1016/j.cger.2010.08.008

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  1. Starting Construction of Frailty Cohort for Elderly and Intervention Study vol.20, pp.3, 2016, https://doi.org/10.4235/agmr.2016.20.3.114
  2. Implications of frailty screening in clinical practice vol.20, pp.1, 2016, https://doi.org/10.1097/mco.0000000000000341
  3. Evaluation and management of frailty vol.60, pp.4, 2016, https://doi.org/10.5124/jkma.2017.60.4.314
  4. Korean version of the Fatigue, Resistance, Ambulation, Illnesses and Loss of weight questionnaire versus the Modified Kihon Checklist for Frailty Screening in Community‐Dwelling Older Adults: Th vol.17, pp.11, 2016, https://doi.org/10.1111/ggi.13017
  5. Urologic symptoms and burden of frailty and geriatric conditions in older men: the Aging Study of PyeongChang Rural Area vol.13, pp.None, 2018, https://doi.org/10.2147/cia.s158717
  6. Usual gait speed is associated with frailty status, institutionalization, and mortality in community-dwelling rural older adults: a longitudinal analysis of the Aging Study of Pyeongchang Rural Area vol.13, pp.None, 2016, https://doi.org/10.2147/cia.s166863
  7. German translation, cross-cultural adaptation and diagnostic test accuracy of three frailty screening tools : PRISMA-7, FRAIL scale and Groningen Frailty Indicator vol.51, pp.3, 2018, https://doi.org/10.1007/s00391-017-1295-2
  8. Comparative effectiveness of fragility fracture integrated rehabilitation management for elderly individuals after hip fracture surgery: A study protocol for a multicenter randomized controlled trial vol.97, pp.20, 2016, https://doi.org/10.1097/md.0000000000010763
  9. Depressive Symptoms and Physical Frailty in Older Adults With Chronic Heart Failure: A Cross-Sectional Study vol.11, pp.3, 2018, https://doi.org/10.3928/19404921-20180207-01
  10. 지역사회 거주 노인의 연령군에 따른 허약수준 관련 요인: 다면적 접근 vol.35, pp.2, 2018, https://doi.org/10.14367/kjhep.2018.35.2.89
  11. The relationship between frailty and polypharmacy in older people: A systematic review vol.84, pp.7, 2016, https://doi.org/10.1111/bcp.13590
  12. Effectiveness of the computerized balance rehabilitation after hip fracture surgery : A study protocol of a prospective and open-label clinical trial vol.97, pp.36, 2016, https://doi.org/10.1097/md.0000000000012199
  13. The Need for Actions Against Polypharmacy in Older People With Frailty vol.22, pp.3, 2018, https://doi.org/10.4235/agmr.2018.22.3.111
  14. Discrepancies in the Prevalence of Known Frailty Scales: Korean Frailty and Aging Cohort Study vol.22, pp.3, 2018, https://doi.org/10.4235/agmr.2018.22.3.137
  15. Health Literacy but Not Frailty Predict Self-Care Behaviors in Patients with Heart Failure vol.15, pp.11, 2016, https://doi.org/10.3390/ijerph15112474
  16. Combined Influence of Depression and Physical Frailty on Cognitive Impairment in Patients with Heart Failure vol.16, pp.1, 2019, https://doi.org/10.3390/ijerph16010066
  17. Factors associated with treatment interruption in elderly patients with cancer vol.34, pp.1, 2019, https://doi.org/10.3904/kjim.2016.318
  18. Instruments for the detection of frailty syndrome in older adults: A systematic review vol.14, pp.4, 2019, https://doi.org/10.1371/journal.pone.0216166
  19. An Optimal Questionnaire Representing Slow Gait Speed(&lt;1m/s) in Community-dwelling Older Adults: The Korean Frailty and Aging Cohort Study (KFACS) vol.23, pp.7, 2016, https://doi.org/10.1007/s12603-019-1213-y
  20. An Optimal Questionnaire Representing Slow Gait Speed(&lt;1m/s) in Community-dwelling Older Adults: The Korean Frailty and Aging Cohort Study (KFACS) vol.23, pp.7, 2016, https://doi.org/10.1007/s12603-019-1213-y
  21. Gender Differences in the Association between Frailty, Cognitive Impairment, and Self-Care Behaviors Among Older Adults with Atrial Fibrillation vol.16, pp.13, 2016, https://doi.org/10.3390/ijerph16132387
  22. Immunogenicity of the Varicella-Zoster Vaccine in Community-Dwelling Non-robust Elderly Individuals Compared to Robust Elderly Individuals: A Prospective Cohort Study vol.74, pp.8, 2016, https://doi.org/10.1093/gerona/gly287
  23. Natural aging course of paraspinal muscle and back extensor strength in community-dwelling older adults (sarcopenia of spine, SarcoSpine): a prospective cohort study protocol vol.9, pp.9, 2016, https://doi.org/10.1136/bmjopen-2019-032443
  24. Is Polypharmacy Associated with Cognitive Frailty in the Elderly? Results from the Korean Frailty and Aging Cohort Study vol.23, pp.10, 2019, https://doi.org/10.1007/s12603-019-1274-y
  25. Functional Outcomes of Fragility Fracture Integrated Rehabilitation Management in Sarcopenic Patients after Hip Fracture Surgery and Predictors of Independent Ambulation vol.23, pp.10, 2016, https://doi.org/10.1007/s12603-019-1289-4
  26. Validation of a Multi–Sensor‐Based Kiosk for Short Physical Performance Battery vol.67, pp.12, 2016, https://doi.org/10.1111/jgs.16135
  27. Polypharmacy and Incident Frailty in a Longitudinal Community‐Based Cohort Study vol.67, pp.12, 2019, https://doi.org/10.1111/jgs.16212
  28. Walking-speed estimation using a single inertial measurement unit for the older adults vol.14, pp.12, 2016, https://doi.org/10.1371/journal.pone.0227075
  29. Diagnostic test accuracy of self‐reported screening instruments in identifying frailty in community‐dwelling older people: A systematic review vol.20, pp.1, 2016, https://doi.org/10.1111/ggi.13810
  30. Functional Age Predicted by Electronic Short Physical Performance Battery Can Detect Frailty Status in Older Adults vol.15, pp.None, 2016, https://doi.org/10.2147/cia.s280542
  31. Caregiving for Community-Dwelling Older Persons in South Korea: Current Formal and Informal Care Use and Expectation vol.39, pp.4, 2016, https://doi.org/10.1177/0733464819866360
  32. Relationship of the pre-operative comprehensive geriatric assessment to length of stay in Korean older adults undergoing spinal surgery vol.32, pp.6, 2020, https://doi.org/10.1007/s40520-019-01300-9
  33. Longitudinal changes in frailty prevalence and related factors in older adults living in long‐term care facilities vol.76, pp.7, 2020, https://doi.org/10.1111/jan.14388
  34. What are the illnesses associated with frailty in community-dwelling older adults: the Korean Frailty and Aging Cohort Study vol.35, pp.4, 2020, https://doi.org/10.3904/kjim.2019.097
  35. An Artificial Neural Network Model for Assessing Frailty-Associated Factors in the Thai Population vol.17, pp.18, 2020, https://doi.org/10.3390/ijerph17186808
  36. Sarcopenia is associated with severe erectile dysfunction in older adults: a population-based cohort study vol.35, pp.5, 2016, https://doi.org/10.3904/kjim.2019.148
  37. Mediating effect of waist:height ratio on the association between BMI and frailty: the Korean Frailty and Aging Cohort Study vol.124, pp.5, 2016, https://doi.org/10.1017/s0007114519002058
  38. Rehabilitation Strategies for Patients with Femoral Neck Fractures in Sarcopenia: A Narrative Review vol.9, pp.10, 2016, https://doi.org/10.3390/jcm9103115
  39. Geriatric management of older patients with multimorbidity vol.20, pp.12, 2016, https://doi.org/10.1111/ggi.14065
  40. Screening Value of Timed Up and Go Test for Frailty and Low Physical Performance in Korean Older Population: The Korean Frailty and Aging Cohort Study (KFACS) vol.24, pp.4, 2016, https://doi.org/10.4235/agmr.20.0072
  41. Combined exercise and nutrition intervention for spinal sarcopenia : A pilot study protocol vol.100, pp.24, 2021, https://doi.org/10.1097/md.0000000000026421
  42. Evaluation of Oral Nutritional Supplementation in the Management of Frailty among the Elderly at Facilities of Community Care for the Elderly vol.10, pp.1, 2021, https://doi.org/10.7762/cnr.2021.10.1.24
  43. The Relationship between Nutrition Status and Risk of Frailty in Cognitive Impaired Elderly in Daycare Center (DC Center) vol.50, pp.1, 2016, https://doi.org/10.3746/jkfn.2021.50.1.88
  44. Pathways among Frailty, Health Literacy, Acculturation, and Social Support of Middle-Aged and Older Korean Immigrants in the USA vol.18, pp.3, 2016, https://doi.org/10.3390/ijerph18031245
  45. Randomized Controlled Trial on the Effects of a Combined Intervention of Computerized Cognitive Training Preceded by Physical Exercise for Improving Frailty Status and Cognitive Function in Older Adul vol.18, pp.4, 2016, https://doi.org/10.3390/ijerph18041396
  46. Validation of the Korean Frailty Index in community-dwelling older adults in a nationwide Korean Frailty and Aging Cohort study vol.36, pp.2, 2016, https://doi.org/10.3904/kjim.2019.172
  47. 농촌 지역 노인의 영양 상태, 근감소증과, 노쇠의 연관성 vol.46, pp.1, 2016, https://doi.org/10.5393/jamch.2021.46.1.023
  48. Multilevel Factors Associated with Frailty among the Rural Elderly in Korea Based on the Ecological Model vol.18, pp.8, 2016, https://doi.org/10.3390/ijerph18084146
  49. Factors Associated with Frailty According to Gender of Older Adults Living Alone vol.9, pp.4, 2016, https://doi.org/10.3390/healthcare9040475
  50. Social factors predicting improvement of frailty in community‐dwelling older adults: Korean Frailty and Aging Cohort Study vol.21, pp.6, 2016, https://doi.org/10.1111/ggi.14160
  51. The Cross-Lagged Panel Analysis between Frailty and Physical Activity among Community-Dwelling Older Adults by Age Groups vol.33, pp.5, 2016, https://doi.org/10.1177/0898264320987365
  52. Correlates of Frailty in Community-Dwelling Older Adults with Cancer: 2017 Survey of Living Condition of Elderly Study in South Korea vol.8, pp.3, 2016, https://doi.org/10.4103/2347-5625.311130
  53. Association of the FRAIL Scale with Geriatric Syndromes and Health-Related Outcomes in Korean Older Adults vol.25, pp.2, 2016, https://doi.org/10.4235/agmr.20.0095
  54. Abdominal obesity, body mass index and the risk of frailty in community-dwelling older adults: a systematic review and meta-analysis vol.50, pp.4, 2016, https://doi.org/10.1093/ageing/afab039
  55. Gender differences in the impact of frailty on 90-day hospital readmission in heart failure patients: a retrospective cohort study vol.20, pp.5, 2016, https://doi.org/10.1093/eurjcn/zvaa028
  56. Clinical Practice Guideline for Frailty Applicable in Primary Care Setting vol.11, pp.4, 2016, https://doi.org/10.21215/kjfp.2021.11.4.223
  57. Validity of the Clinical Frailty Scale in Korean older patients at a geriatric clinic vol.36, pp.5, 2021, https://doi.org/10.3904/kjim.2020.652
  58. Clinical Frailty Scale, K-FRAIL questionnaire, and clinical outcomes in an acute hospitalist unit in Korea vol.36, pp.5, 2016, https://doi.org/10.3904/kjim.2020.677
  59. Polypharmacy Is Significantly and Positively Associated with the Frailty Status Assessed Using the 5-Item FRAIL Scale, Cardiovascular Health Phenotypic Classification of Frailty Index, and Study of Os vol.10, pp.19, 2016, https://doi.org/10.3390/jcm10194413
  60. 광주광역시 서구 재가노인의 노쇠정도에 따른 영양상태 vol.26, pp.5, 2021, https://doi.org/10.5720/kjcn.2021.26.5.382
  61. Clinical Practice Guidelines for Managing Frailty in Community-Dwelling Korean Elderly Adults in Primary Care Settings vol.42, pp.6, 2016, https://doi.org/10.4082/kjfm.21.0162
  62. Central Sarcopenia, Frailty and Comorbidity as Predictor of Surgical Outcome in Elderly Patients with Degenerative Spine Disease vol.64, pp.6, 2021, https://doi.org/10.3340/jkns.2021.0074
  63. Translation and validation of the Korean version of the clinical frailty scale in older patients vol.21, pp.1, 2016, https://doi.org/10.1186/s12877-021-02008-0
  64. Influence of comorbidities on functional outcomes in patients with surgically treated fragility hip fractures: a retrospective cohort study vol.21, pp.1, 2016, https://doi.org/10.1186/s12877-021-02227-5