Brody et al developed a self-reporting screening instrument to identify elderly patients likely to develop frailty (as defined as the need for being placed in a nursing home or receive long term home care) within 1 year. This can help identify older patients who may require closer monitoring and more aggressive intervention. The authors are from Kaiser Permanente and the University of Florida.
Parameters associated with onset of frailty within 1 year:
(1) age in years
(2) health conditions interfere with daily activities
(3) needs assistance taking a bath
(4) needs assistance in taking medication
|
Parameter |
Finding |
Points |
|
age in years |
|
(age) |
|
Do health conditions interfere with daily activities? |
no |
0 |
|
|
yes |
1 |
|
Is assistance required in bathing? |
no |
0 |
|
|
yes |
1 |
|
Is assistance required in taking medications? |
no |
0 |
|
|
yes |
1 |
|
Parameter |
Parameter Estimate |
Odds Ratio |
95% CI |
|
age |
0.09 |
1.09 |
1.07 – 1.11 |
|
health conditions interfere |
0.99 |
2.69 |
2.10 – 3.44 |
|
assistance with bath |
2.55 |
12.87 |
8.90-18.60 |
|
assistance with medications |
2.80 |
16.37 |
11.11 – 24.12 |
from Table 4, page 188
X =
= (0.09 * (age in years)) + (0.99 * (points for health conditions)) + (2.55 * (points for bathing assistance)) + (2.80 * (points for taking medications)) – 9.79
probability of requiring nursing home or home care interventions during the next year =
= 1 / (1 + EXP((-1)* X)))
where:
• On page 189 it states that the probability of frailty in a 67 year old person with no other risk factors was 2%; for a 100 year old patient with no other risk factors the risk was 30%.
Limitations:
• The study involved patients enrolled in a Social HMO program administered by Kaiser Permanente and might not apply to all elderly patients.
Purpose: To identify an elderly patient likely to become frail during the next year using the self-reported screening instrument of Brody et al.
Specialty: Sports Medicine & Rehabilitation
Objective: disability and performance, quality of life
ICD-10: ,
