Details of Publication 563 for Project A358:

Lopez D, Flicker L & Dobson A. Validation of the Frail Scale in a cohort of older Australian women. JAGS, 2012; 60(1): 171-173

Background: There is a need for a simple frailty assessment tool for use in large-scale epidemiological studies. The FRAIL scale is based on five domains: fatigue, resistance (ability to climb a single flight of stairs), ambulation (ability to walk 100m), illnesses (>5) and loss of more than 5% of weight. The aims of this study are to validate the FRAIL scale in a cohort of older Australian women and to determine whether a score greater than 2 on this scale is predictive of frailty.Methods: Data were obtained from the 1921-1926 birth cohort at survey 2 (1999), survey 3 (2002) and survey 5 (2008). Assessment of frailty was calculated from responses to the SF-36 (fatigue, resistance and ambulation), more than five chronic conditions (Alzheimer’s disease, dementia, angina, heart attack, depression, arthritis, asthma, bronchitis or emphysema, diabetes mellitus, hypertension, osteoporosis and stroke), and self-reported weight. Women were considered frail if they scored >2 on the FRAIL scale. Dependent variables were date of death or survival at October 31, 2009 and activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Covariates included age, BMI, education and living alone.Results: The FRAIL scale predicted all-cause mortality and disability in a graded manner (P for trend <0.05). Women who scored >2 on the FRAIL scale in 2002 had a hazard ratio for death of 2.68 (95% confidence interval (CI) 2.42-2.99) compared with those women who scored 0. Women who were assessed as frail (FRAIL scale >2) were also at greater risk of subsequent disability (ADLs - odds ratio (OR) 3.63, 95%CI 3.05-4.32; IADLS - OR 4.90, 95%CI 3.67-6.54) than women who scored 0.Conclusion: The FRAIL scale is a simple measure of frailty and is predictive of mortality and disability. This scale may have applications for clinicians and researchers, but requires further validation against established criteria.