Assessing the Edmonton Frail Scale, Multidimensional Geriatric Conditions

Authors of study recently published in BMC Geriatrics found that the Edmonton Frail Scale (EFS) can be a helpful and potentially cost-effective performance tool in order to stratify the state of frailty in long-term care residents and upon hospital admissions (published online January 4, 2017).

Physicians have often used the term frailty to characterize the weakest and most vulnerable subset of older adults. However, the line between age and frailty appears to be so blurred that it has been hypothesized that everyone becomes frail when they grow old.

For this study, authors aimed to evaluate the performance of Edmonton Frail Scale (EFS) on frailty assessment in association with multidimensional conditions assessed with specific screening tools and to explore the prevalence of frailty by gender.

The EFS was first given to 366 hospitalized patients—251 women and 115 with a mean age of 81.5 years—to evaluate frailty. Then, data concerning cognitive status was collected via: the Mini-Mental State Examination (MMSE); health status (evaluated with the number of diseases); functional independence (Barthel Index and Activities Daily Living); use of drugs (number of drugs taken every day); the Mini Nutritional Assessment (MNA); the Geriatric Depression Scale (GDS); the Skeletal Muscle Index of sarcopenia (SMI); and osteoporosis and functionality (handgrip strength).

According to the results of the EFS scores, 19.7% of subjects were classified as nonfrail, 66.4% as apparently vulnerable, and 13.9% as severely frail. Overall, the EFS scores were associated with cognition, functional independence, use of medications, nutrition, mood, and functional performance, but not with number of comorbidities. IN addition, in osteoporotic patients vs non-osteoporotic patients, the mean EFS score did not differ between groups (women: P = 0.365; men: P = .088), whereas in sarcopenic vs non-sarcopenic patients, there was a significant difference in women: P < .05.

Authors conclude that the EFS is an effective tool to determine frailty This conclusion follows other similar, less broad studies; the team demonstrated a significant association with other frailty screening tools. The authors also point out the potential of the scale as a low-cost and convenient performance screening tool to assess frailty upon hospital admissions.—Amanda Del Signore