Validation of “(fr)AGILE”: a quick tool to identify multidimensional frailty in the elderly

BMC Geriatrics

David Della-Morte¹  Francesco Cacciatore²  Pasquale Abete²  Ilaria Liguori²  Gennaro Russo²  Veronica Flocco²  Giulia Bulli²  Domenico Bonaduce²  Francesco Curcio²  Gianluca Testa³  Gianlugi Galizia⁴  Gaetano Gargiulo⁵ 

[1] Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy;San Raffaele Roma Open University, Rome, Italy;Department of Translational Medical Sciences, University of Naples “Federico II”, Via S. Pansini, 80131, Naples, Italy;Department of Translational Medical Sciences, University of Naples “Federico II”, Via S. Pansini, 80131, Naples, Italy;Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy;Department of Translational Medical Sciences, University of Naples “Federico II”, Via S. Pansini, 80131, Naples, Italy;IRCCS Salvatore Maugeri Foundation, Scientific Institute of Veruno, Novara, Italy;Division of Internal Medicine, AOU San Giovanni di Dio e Ruggi di Aragona, Salerno, Italy;

关键词: Frailty;    Multidimensional;    Comprehensive geriatric assessment;   

DOI  :  10.1186/s12877-020-01788-1

来源: Springer

【 摘 要 】

BackgroundSeveral tools have been proposed and validated to operationally define frailty. Recently, the Italian Frailty index (IFi), an Italian modified version of Frailty index, has been validated but its use in clinical practice is limited by long time of administration. Therefore, the aim of this study was to create and validate a quick version of the IFi (AGILE).MethodsValidation study was performed by administering IFi and AGILE, after a Comprehensive Geriatric Assessment (CGA) in 401 subjects aged 65 or over (77 ± 7 years). AGILE was a 10-items tool created starting from the more predictive items of the four domains of frailty investigated by IFi (mental, physical, socioeconomic and nutritional). AGILE scores were stratified in light, moderate and severe frailty. At 24 months of follow-up, death, disability (taking into account an increase in ADL lost ≥1 from the baseline) and hospitalization were considered. Area under curve (AUC) was evaluated for both IFi and AGILE.ResultsAdministration time was 9.5 ± 3.8 min for IFi administered after a CGA, and 2.4 ± 1.2 min for AGILE, regardless of CGA (p < 0.001). With increasing degree of frailty, prevalence of mortality increased progressively from 6.5 to 41.8% and from 9.0 to 33.3%, disability from 16.1 to 64.2% and from 22.1 to 59.8% and hospitalization from 17.2 to 58.7% and from 27.0 to 52.2% with AGILE and IFi, respectively (p = NS). Relative Risk for each unit of increase in AGILE was 56, 44 and 24% for mortality, disability and hospitalization, respectively and was lower for IFi (8, 7 and 4% for mortality, disability and hospitalization, respectively). The AUC was higher in AGILE vs. IFi for mortality (0.729 vs. 0.698), disability (0.715 vs. 0.682) and hospitalization (0.645 vs. 0.630).ConclusionsOur study shows that AGILE is a rapid and effective tool for screening multidimensional frailty, able to predict mortality, disability and hospitalization, especially useful in care settings that require reliable assessment instruments with short administration time.

【 授权许可】

CC BY