Validation of Instruments to Classify the Frailty of the Elderly in Community

Article information

Res Community Public Health Nurs. 2011;22(3):302-314

Publication date (electronic) : 2014 April 04

doi : https://doi.org/10.12799/jkachn.2011.22.3.302

Insook Lee ¹, Young Im Park ², Eunok Park ³, Soon Hee Lee ⁴, Ihn Sook Jeong ⁵

¹Professor, College of Nursing, Seoul National University, Korea.

²Professor, Department of Nursing, Daejeon University, Korea.

³Professor, College of Nursing, Jeju National University, Korea.

⁴Professor, Department of Nursing, Chungju National University, Korea.

⁵Associate Professor, College of Nursing, Pusan National University, Korea.

Address reprint requests to: Jeong, Ihn Sook, College of Nursing, Pusan National University, Beomoe-ri, Mulgeum-eup, Yangsan 626-870, Korea. Tel: 82-51-510-8342, Fax: 82-51-510-8308, jeongis@pusan.ac.kr

Received 2011 August 11; Revised 2011 September 19; Accepted 2011 September 19.

Abstract

Purpose

This study aimed to validate instruments to classify the frailty of Korean elderly people in community.

Methods

For this study, 632 elders were selected from community-based elderly houses and home visiting registries, and data on frailty were collected using three instruments during November, 2008. The Korean Frail Scale (KFS) was composed of 10 domains with the maximum score of 20. The Edmonton Frail Scale (EFS) had 10 domains with the maximum score of 17. The 25_Japan Frail Scale (25_JFS) was composed of 6 domains with the maximum score of 25. Internal consistency was measured with Cronbach's α. Sensitivity, specificity and area under the curve (AUC) of ROC were measured to see validity with long-term care insurance grade as a gold standard.

Results

The Cronbach's α was .72 for KFS, .55 for EFS, and .80 for 25_JFS. Sensitivity, specificity, and AUC were 70.0%, 83.2%, and .83, respectively, at cutting point 10.5 for the KFS, 50.0%, 80.9%, and .66, respectively, at 8.5 for EFS, and 80.0%, 85.9%, and .86, respectively, at 12.5 for 25_JFS.

Conclusion

KFS and three JFS showed favorable internal consistency and predictive validity. Further longitudinal studies are recommended to confirm predictive validity.

Keywords: Frail elderly; Sensitivity; Specificity; Area under curve

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Figure 1

Receiver operating characteristics curves and area under the curves (AUC) for upper limit (a) and for lower limit of frailty (b).

Table 1

Components of Frail Scales Used in This Study

n=number of items.

^†'Depression 5 items' in 25point-Japan Frail Scale was replaced with Geriatric Depression Scale in 22 point-Japan Frail Scale.

^‡'Timed Up & Go', 'Sensation', 'Present disease were added in 31 point-Japan Frail Scale.

^§When KDSQ-C is needed, the total items are 68.

Table 2

Distribution of Each Instrument Scoring by General Characteristics of Participants

KFS=Korea frail scale; EFS=edmonton frail scale; 22-JFS=22 point-Japan frail scale; 25-JFS=25 point-Japan frail scale; 31-JFS=31 point-Japan frail scale; SCC=senior citizen's centers; HVP=home visiting projects.

^†M±SD=75.8±5.8

Table 3

Cronbach's alpha and Area Under the ROC Curve by General Characteristics

Table 4

Cronbach's alpha, Sensitivity and Specificity at Certain Cutting Points

^†Coverage between upper limit's and lower limit's cutting point.