Postal screening can identify frailty and predict poor outcomes in older adults: longitudinal data from INTER-FRAIL study

• Published in: Age and ageing Vol. 45; no. 4; pp. 469 - 474
• Main Authors: Mossello, Enrico, Profili, Francesco, Di Bari, Mauro, Bandinelli, Stefania, Razzanelli, Matilde, Salvioni, Anna, Corridori, Carla, Di Fiandra, Teresa, Francesconi, Paolo
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.07.2016
• Subjects: Age Factors; Aged; Aged, 80 and over; Aging; Emergency Service, Hospital - utilization; Female; Frail Elderly; Frailty - diagnosis; Frailty - epidemiology; Frailty - therapy; Geriatric Assessment - methods; Health aspects; Health Resources - utilization; Health risk assessment; Humans; Italy - epidemiology; Long-Term Care - utilization; Longitudinal Studies; Male; Mass Screening - methods; Medical examination; Patient Admission; Postal Service; Predictive Value of Tests; Prognosis; Prospective Studies; Reproducibility of Results; Surveys and Questionnaires; Time Factors; frailty; older people; postal screening; prognosis
• ISSN: 0002-0729; 1468-2834
• DOI: 10.1093/ageing/afw048

identification of older individuals at risk for health-related adverse outcomes (HRAO) is necessary for population-based preventive interventions. Aim of this study was to improve a previously validated postal screening questionnaire for frailty in non-disabled older subjects and to test its prognostic validity in a vast sample of older community-dwellers. individuals aged 70+ underwent a mass postal screening. Physical frailty phenotype (PFP) was assessed in the unselected subsample of the first responders. After a 1-year follow-up, HRAO were recorded in the whole sample, including survival, access to Emergency Department, hospitalisation and Long-Term Care admission. the questionnaire was mailed to 17,273 subjects, whose response rate was 55%. Among the first 1,037 responders without overt disability, the revised questionnaire was 75% sensitive and 69% specific for PFP (ROC 0.772). Non-disabled subjects who screened positive had a higher risk of HRAO in comparison with those who screened negative and similar to non-responders. Risk of adverse outcome was highest among disabled subjects. a simple questionnaire delivered by mail has good accuracy in detecting PFP in non-disabled older subjects and is able to predict HRAO.