A cohort of 803 community dwelling older adults were scored for frailty by their public health nurse (PHN) using the Clinical Frailty Scale CFSS) and for risk of three adverse outcomes: i) institutionalisation, ii) hospitalisation and iii) death, within the next year, from one (lowest) to five (highest) using the RISC.
Scoring for each frailty component is described in the Additional file 1. Psychosocial measures were also performed at admission.
At baseline, 11 of 29 patients with available VES-13 scores met the definition for frailty.
This also enabled us to develop a reliable measure that translated into a frailty score for use in future analyses.
The Geriatric Status Score was developed at this institution [ 24], and used as the basis of a frailty score for community populations [ 25, 26].
The raw frailty score for a new individual, i, can be expressed as follows: DFactor score(i) = z fat w fat (i) + z loss w loss (i) + z grip w grip (i) + z fdiff w fdiff (i) + z act w act (i), where FAT is fatigue, LOSS is loss of appetite, GRIP is grip strength, FDIFF is functional difficulties and ACT is physical activity, as defined in the above frailty definition.
The strongest predictive model for frailty was scoring positive on ≥3 VMS domains if aged 70 80 years; or being aged ≥80 years and scoring positive on ≥1 VMS domains.
Of 5104 participants who completed a baseline assessment from August 2011 to February 2012, 763 had a history of Parkinson's disease (n=23), stroke (n=281), MMSE scores of <18 (n=31), missing data for frailty phenotype (n=249), were already using the LTCI system (n=124) at baseline, or had missing follow-up data (n=55), and were excluded from further analyses (figure 1).
The use of CVD risk scores in clinical practice may also have utility for frailty prediction.
