![]() 2 Despite its strong predictive validity, 2, 14, 15 this approach is time-consuming and not widely used clinically. Summing the number of impairments is another way to define frailty. 5 Rules-based definitions often are derived from multiple regression analyses and can be speciously precise, for example in requiring combinations of factors that might not apply to an individual case. 1, 2, 3, 4, 5, 6, 7, 8 There are many operational definitions, 1, 5, 9, 10, 11, 12, 13 which typically are rules-based for example, a person may be defined as frail if 3 or more symptoms (of unintentional weight loss, feeling exhausted, weak grip strength, slow walking speed and low physical activity) are present. It appears to be a valid construct, but how exactly to define it remains unclear. Clinical judgments about frailty can yield useful predictive information.įrailty is a term widely used to denote a multidimensional syndrome of loss of reserves (energy, physical ability, cognition, health) that gives rise to vulnerability. Interpretation: Frailty is a valid and clinically important construct that is recognizable by physicians. Analyses of receiver operating characteristic curves showed that our Clinical Frailty Scale performed better than measures of cognition, function or comorbidity in assessing risk for death (area under the curve 0.77 for 18-month and 0.70 for 70-month mortality). Each 1-category increment of our scale significantly increased the medium-term risks of death (21.2% within about 70 mo, 95% confidence interval 12.5%–30.6%) and entry into an institution (23.9%, 95% CI 8.8%–41.2%) in multivariable models that adjusted for age, sex and education. Results: The CSHA Clinical Frailty Scale was highly correlated ( r = 0.80) with the Frailty Index. We followed this cohort prospectively after 5 years, we determined the ability of the Clinical Frailty Scale to predict death or need for institutional care, and correlated the results with those obtained from other established tools. Methods: We developed the 7-point Clinical Frailty Scale and applied it and other established tools that measure frailty to 2305 elderly patients who participated in the second stage of the Canadian Study of Health and Aging (CSHA). ![]() ![]() We aimed to develop a tool that would be both predictive and easy to use. Previously developed tools to assess frailty that have been shown to be predictive of death or need for entry into an institutional facility have not gained acceptance among practising clinicians. Background: There is no single generally accepted clinical definition of frailty. ![]()
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