Sensitivity and Specificity of a Short Questionnaire to Screen Frailty in the Community-Dwelling Older Population

Abstract

Introduction. Frailty represents a major risk factor for death and Use of Hospital Services (UHS) among older adults. A simple tool to detect frailty might permit stratification of the community-dwelling older population according to the risk of negative outcomes. The present study aims at determining the sensitivity and specificity in predicting mortality and UHS of the Short Functional Geriatric Evaluation (SFGE), a short questionnaire to screen for frailty in community-dwelling older citizens. Methods. The study is a secondary analysis of all the data collected through an observational longitudinal cohort study carried out in Lazio region (Italy). The SFGE is compared with the Functional Geriatric Evaluation (FGE) questionnaire to define sensitivity and specificity for mortality and for UHS during the first year following its administration. Results. The SFGE classifies 36.3% of the respondents as frail and shows a sensitivity of 90.4% and a specificity of 78.3% compared to the FGE (area under the ROC: 0.928; CL95%: 0.910 - 0.947; p-value < 0.001). Those respondents identified by the SFGE as frail also include some of those classified by the FGE as pre-frail, who also show a high rate of UHS. The results show that the SFGE score predicts the UHS more accurately than it does the mortality rate. Conclusion. The SFGE identifies as frail a larger portion of the enrolled population than the FGE. Those people so identified show a high rate of UHS. Because of its easy and quick administration, it can be considered a useful primary screening tool but it must be followed up with a more extensive assessment of those identified as frail. The small time needed to fill in the tool and the possibility of administering it by telephone makes the SFGE a useful tool to screen for frailty and to plan the provision of care services at both individual and population level.