Assessing frailty in older adults

Introduction Frailty is prevalent among older adults and is a growing public health concern. Physical activity questionnaires are pragmatic tools for screening; however, their discriminative capacity remains uncertain. This study aimed to determine the discriminative performance and optimal cut-offs of the International Physical Activity Questionnaire–Short Form (IPAQ-SF) and the Physical Activity Scale for the Elderly (PASE) for identifying frailty states (non-frail, pre-frail, and frail) in a clinically derived cohort of older adults. Methods The study enrolled 289 older adults who were assessed using a demographic form, the FRAIL Scale, the IPAQ-SF, and the PASE. Frailty discrimination was evaluated via receiver operating characteristic analysis (ROC); optimal thresholds were identified using the Youden index, diagnostic indices (sensitivity, specificity, accuracy, predictive values) were computed, micro-/macro- area under the curves (AUC) were reported, and scale AUCs were compared using the DeLong test. Results Participants had a mean age of 72.5 ± 7.0 years, and 56.7% were women. Frailty prevalence was 31.1% non-frail, 29.4% pre-frail, and 39.4% frail. For IPAQ-SF, AUCs were 0.45 (non-frail), 0.40 (pre-frail), and 0.67 (frail); for PASE, AUCs were 0.39 (non-frail), 0.50 (pre-frail), and 0.65 (frail). Macro−/micro-AUCs were 0.51/0.53 for IPAQ-SF and 0.51/0.52 for PASE. No significant differences were found between the two instruments across the frailty categories (DeLong test, p > 0.05). At optimal cut-offs (IPAQ-SF ≤ 322.5; PASE ≤ 63.6), both questionnaires showed moderate agreement with the FRAIL Scale ( κ = 0.46–0.48), whereas agreement between the instruments was only low-to-moderate ( κ = 0.32, McNemar p = 0.015). Conclusion IPAQ-SF and PASE demonstrated limited ability to discriminate frailty status in older adults, with moderate accuracy in identifying frail individuals and poor discrimination between the non-frail and pre-frail groups. The IPAQ-SF showed slightly higher specificity, whereas the PASE demonstrated higher sensitivity, indicating that they capture distinct aspects of physical activity behavior but cannot be used interchangeably

Activities of daily living · Discriminative model · MEDLINE · Physical activity · Frailty in Older Adults · Nutrition and Health in Aging · Physical Activity and Health

• Prevalence of Frailty in Middle-Aged and Older Community-Dwelling Europeans Living in 10 Countries

  Brigitte Santos-Eggimann, Philippe Cuénoud et al.•The Journals of Gerontology…•2009

  Añadir item

• A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans

  Open Access•John E Morley, Theodore K Malmstrom et al.•The Journal of nutrition, health…•2012

  Añadir item

• The Frailty Syndrome

  Open Access•Qian-Li Xue, Qian‐Li Xue•Clinics in Geriatric Medicine•2011

  Añadir item

• The physical activity scale for the elderly (Pase)

  Open Access•Richard A Washburn, Kevin Smith et al.•Journal of Clinical Epidemiology•1993

  Añadir item

• Management of frailty

  Open Access•Elsa Dent, Finbarr C Martins et al.•The Lancet•2019

  Añadir item

• Validity of the international physical activity questionnaire short form (Ipaq-SF)

  Open Access•Paul H Lee, Duncan J Macfarlane et al.•International Journal of…•2011

  Añadir item

• The meaning and use of the area under a receiver operating characteristic (ROC) curve.

  J A Hanley, Barbara J Mcneil•Radiology•1982

  Añadir item

• Frailty in Older Adults

  Linda P Fried, Catherine M Tangen et al.•The Journals of Gerontology…•2001

  Añadir item

• Associations of physical activity participation trajectories with subsequent motor function declines and incident frailty

  Open Access•Yang Wang, Chenglong Li et al.•Frontiers in Psychiatry•2022

  Añadir item

• Association between frailty and the combination of physical activity level and sedentary behavior in older adults

  Open Access•Venicius Dantas da Silva, Sheilla Tribe et al.•BMC Public Health•2019

  Añadir item