ASSOCIATION BETWEEN FUNCTIONAL ASSESSMENT INSTRUMENTS AND FRAILTY IN OLDER ADULTS: THE FRADEA STUDY

Abstract

Objectives:To determine the association between functional assessment instruments and frailty.Design:Concurrent cohort study. Setting:Albacete Health Area (Spain). Participants:993 subjects aged ≥ 70years, participating in the FRADEA Study. Measurements:The following functional instruments were applied:Barthel index, Lawton index and Short Form-Late Life Function and Disability Instrument (SF-LLFDI) asdisability questionnaires; Holden ́s Functional Ambulation Classification (FAC) as ambulation scale, and sevenperformance tests: gait speed (m/s), Timed up and go (TUG) (sec), unipodal balance time (sec), 5-chair-sit-to-stand test (sec), Short Physical Performance Battery (SPPB), hand grip strength (kg) and elbow flexion strength(kg). Frailty was assessed by Fried ́s criteria. The association between functional instruments and frailty wasassessed, ROC curves were constructed and the area under the curves (AUC) calculated. The best cut-point wasidentified for each instrument and their sensitivity (S) and specificity (SP) are described. Results:16.9%participants were frail. The AUC, best cut-point, S and SP for each instrument were respectively: Barthel (0.916;≤ 85; 0.90, 0.82), Lawton (0.917; ≤ 3; 0.86, 0.93), SF-LLFDI (0.948; ≤ 90; 0.87, 0.91), FAC (0.885; ≤ 4; 0.81,0.83), gait speed (0.938; ≤ 0.62; 0.90, 0.90), TUG (0.984; ≥ 17.8; 0.93, 0.98), unipodal balance time (0.753; ≤ 5;0.73, 0.71), 5-chair-sit-to-stand test (0.880; ≥ 15; 0.78, 0.76), SPPB (0.956; ≤ 6; 0.88, 0.88), hand grip strength(0.807; ≤ 26; 0.75, 0.75) and elbow flexion strength (0.924; ≤ 15; 0.89, 0.87). Conclusion:The best performancetests to identify frail subjects are the Timed Up and Go test, gait speed and the SPPB, and the best questionnaireis the SF-LLFDI.