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

Age Ageing. 2016 Jul;45(4):469-74. doi: 10.1093/ageing/afw048. Epub 2016 Mar 23.

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusions: a simple questionnaire delivered by mail has good accuracy in detecting PFP in non-disabled older subjects and is able to predict HRAO.

Keywords: frailty; older people; postal screening; prognosis.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aging*
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Frail Elderly*
  • Frailty / diagnosis*
  • Frailty / epidemiology
  • Frailty / therapy
  • Geriatric Assessment / methods*
  • Health Resources / statistics & numerical data
  • Humans
  • Italy / epidemiology
  • Long-Term Care / statistics & numerical data
  • Longitudinal Studies
  • Male
  • Mass Screening / methods*
  • Patient Admission
  • Postal Service*
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Reproducibility of Results
  • Surveys and Questionnaires*
  • Time Factors