The authors have no financial or personal conflicts of interest.
The assessment of frailty in older people in acute care
Article first published online: 24 NOV 2009
© 2009 The Authors. Journal compilation © 2009 ACOTA
Australasian Journal on Ageing
Volume 28, Issue 4, pages 182–188, December 2009
How to Cite
Hilmer, S. N., Perera, V., Mitchell, S., Murnion, B. P., Dent, J., Bajorek, B., Matthews, S. and Rolfson, D. B. (2009), The assessment of frailty in older people in acute care. Australasian Journal on Ageing, 28: 182–188. doi: 10.1111/j.1741-6612.2009.00367.x
There was no specific funding for this project, which was carried out by staff and students of the Royal North Shore Hospital and University of Sydney.
- Issue published online: 24 NOV 2009
- Article first published online: 24 NOV 2009
- acute care;
- acute illness;
- geriatric medicine
Aim: Develop a measure of frailty for older acute inpatients to be performed by non-geriatricians.
Method: The Reported Edmonton Frail Scale (REFS) was adapted from the Edmonton Frail Scale for use with Australian acute inpatients. With acute patients aged over 70 years admitted to an Australian teaching hospital, we validated REFS against the Geriatrician's Clinical Impression of Frailty (GCIF), measures of cognition, comorbidity and function, and assessed inter-rater reliability.
Results: REFS was moderately correlated with GCIF (n = 105, R = 0.61, P < 0.01), Mini-Mental State Examination impairment (n = 61, R = 0.49, P < 0.001), Charlson Comorbidity Index (n = 59, R = 0.51, P < 0.001) and Katz Daily Living Scale (n = 59, R = 0.51, P < 0.001). Inter-rater reliability of REFS administered by two researchers without medical training was excellent (kappa = 0.84, n = 31).
Conclusion: In this cohort of older acute inpatients, REFS is a valid, reliable test of frailty, and may be a valuable research tool to assess the impact of frailty on prognosis and response to therapy.