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https://hdl.handle.net/2440/134271
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Type: | Journal article |
Title: | The FRAIL-NH Scale: Systematic Review of the Use, Validity and Adaptations for Frailty Screening in Nursing Homes |
Author: | Liau, S.J. Lalic, S. Visvanathan, R. Dowd, L.A. Bell, J.S. |
Citation: | Journal of Nutrition, Health and Aging, 2021; 25(10):1205-1216 |
Publisher: | Springer-Verlag |
Issue Date: | 2021 |
ISSN: | 1279-7707 1760-4788 |
Statement of Responsibility: | S.J. Liau, S. Lalic, R. Visvanathan, L.A. Dowd, J.S. Bell |
Abstract: | OBJECTIVES: To investigate frailty prevalence, cross-sectional associations, predictive validity, concurrent validity, and cross-cultural adaptations of the FRAIL-NH scale. DESIGN: Systematic review. SETTING AND PARTICIPANTS: Frail residents living in nursing homes. METHODS: MEDLINE, EMBASE, CINAHL, and Cochrane Library were searched from January 2015 to June 2021 for primary studies that used the FRAIL-NH scale, irrespective of study designs and publication language. RESULTS: Overall, 40 studies conducted across 20 countries utilized the FRAIL-NH scale; majority in Australia (n=14), followed by China (n=6), United States (n=3), and Spain (n=3). The scale has been translated and back-translated into Brazilian Portuguese, Chinese, and Japanese. Various cut-offs have been used, with ≥2 and ≥6 being the most common cut-offs for frail and most frail, respectively. When defined using these cut-offs, frailty prevalence varied from 15.1-79.5% (frail) to 28.5-75.0% (most frail). FRAIL-NH predicted falls (n=2), hospitalization or length of stay (n=4), functional or cognitive decline (n=4), and mortality (n=9) over a median follow-up of 12 months. FRAIL-NH has been compared to 16 other scales, and was correlated with Fried’s phenotype (FP), Frailty Index (FI), and FI-Lab. Four studies reported fair-to-moderate agreements between FRAIL-NH and FI, FP, and the Comprehensive Geriatric Assessment. Ten studies assessed the sensitivity and specificity of different FRAIL-NH cut- offs, with ≥8 having the highest sensitivity (94.1%) and specificity (82.8%) for classifying residents as frail based on FI, while two studies reported an optimal cut-off of ≥2 based on FI and FP, respectively. CONCLUSION: In seven years, the FRAIL-NH scale has been applied in 20 countries and adapted into three languages. Despite being applied with a range of cut-offs, FRAIL-NH was associated with higher care needs and demonstrated good agreement with other well-established but more complex scales. FRAIL-NH was predictive of adverse outcomes across different settings, highlighting its value in guiding care for frail residents in nursing homes. |
Keywords: | FRAIL-NH; frailty; frail older adults; nursing homes; residential facilities |
Description: | Published online October 27, 2021 |
Rights: | © Serdi and Springer-Verlag International SAS, part of Springer Nature |
DOI: | 10.1007/s12603-021-1694-3 |
Published version: | http://dx.doi.org/10.1007/s12603-021-1694-3 |
Appears in Collections: | Medicine publications |
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