To propose a simple frailty screening tool able to identify frailty profiles.
Cross-sectional observational study.
Participants were recruited in 3 different clinical settings: a primary care outpatient clinic (RURAL population, N=591), a geriatric day clinic (DAY-CLINIC population, N=76) and healthy volunteers (URBAN population, N=147).
A total of 817 older adults (>70 years old) living at home were included.
A 9-item questionnaire (Lorraine Frailty Profiling Screening Scale, LoFProSS), constructed by an experts’ working group, was administered to participants by health professionals.
A Multiple Correspondence Analysis (MCA) followed by a hierarchical clustering of the results of the MCA performed in each population was conducted to identify participant profiles based on their answers to LoFProSS. A response pattern algorithm was resultantly identified in the RURAL (main) population and subsequently applied to the URBAN and DAY-CLINIC populations and, in these populations, the two classification methods were compared. Finally, clinically-relevant profiles were generated and compared for their ability to similarly classify subjects.
The response pattern differed between the 3 sub-populations for all 9 items, revealing significant intergroup differences (1.2±1.4 positive responses for URBAN vs. 2.1±1.3 for RURAL vs. 3.1+2.1 for DAY-CLINIC, all p<0.05). Five clusters were highlighted in the main RURAL population: “non-frail”, “hospitalizations”, “physical problems”, “social isolation” and “behavioral”, with similar clusters highlighted in the remaining two populations. Identification of the response pattern algorithm in the RURAL population yielded a second classification approach, with 83% of tested participants classified in the same cluster using the 2 different approaches. Three clinically-relevant profiles (“non-frail” profile, “physical frailty and diseases” profile and “cognitive-psychological frailty” profile) were subsequently generated from the 5 clusters. A similar double classification approach as above was applied to these 3 profiles revealing a very high percentage (95.6%) of similar profile classifications using both methods.
The present results demonstrate the ability of LoFProSS to highlight 3 frailty-related profiles, in a consistent manner, among different older populations living at home. Such scale could represent an added value as a simple frailty screening tool for accelerated and better-targeted investigations and interventions.
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This work was supported by the European FrailSafe project (H2020-PHC-2014-2015, Contract number 690140), the French national PHRC 2010-A01399-30 program, the regional CPER-ITM2P 2015–2020 project, the French «Lorraine Université d’Excellence» PIA project, reference ANR-15-IDEX-04-LUE and the Investments for the Future program under grant agreement No. ANR-15-RHU-0004. The authors thank the Agence Régionale de Santé (ARS) de Lorraine for supporting this study. The authors thank the Filleris group for its contribution in the conduct of this study and in particular the individuals of this group mentioned below who actively participated in the geriatric evaluations: Dr C. Berard, Dr F. Block, Mrs MF. Cangini, Mrs C. Clement, Dr J. Crestani, Mrs F. Delesse, Mrs F. Iochem, Mrs P. Leroij, Mrs C. Lesniak, Dr F. Sprenger, Dr D. Stock, Dr M. Wilczewski, Dr M. Zanetti. We also thank the personnel of the CHRU Nancy for the assessments of the URBAN and DAY-CLINIC participants. Special thanks are also given to Mrs F. Bardin, ANGDM (Agence Nationale Pour La Garantie Des Droits Des Mineurs — National Agency for the Rights of Miners).
Disclosure of conflict of inetrest: Authors have no potential conflict of interest to report.
Ethical Standards: Participants of the URBAN population signed an informed consent. For subjects of the DAY-CLINIC and RURAL populations, current policy regarding data collection for research purposes during standard clinical practice was applied (subjects underwent this questionnaire in the context of their routine examination and were informed prior to the interview regarding the anonymous use of these explorations for the purpose of the present clinical study and were given the opportunity to express their opposition, in which case their responses were not recorded).
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Kotsani, M., Aromatario, O., Labat, C. et al. A Simple Questionnaire as a First-Step Tool to Detect Specific Frailty Profiles: The Lorraine Frailty-Profiling Screening Scale. J Nutr Health Aging (2020). https://doi.org/10.1007/s12603-020-1420-6