Patient selection: >= 65 years of age in Japan
Parameters:
(1) fatigue: feel that everything done is an effort in the last month
(2) resistance: climbing stairs without using the handrail or wall for support
(3) ambulation: difficulty walking 1 km without resting and without walking aids by self
(4) inactivity: sitting or lying down for more than 80% of waking time
(5) loss of weight: unintentional weight loss > 2-3 kg in the past 6 months
|
Parameters
|
Finding
|
Points
|
|
fatigue
|
most of the time
|
1
|
|
|
some of the time
|
1
|
|
|
a little of the time
|
0
|
|
|
none of the time
|
0
|
|
resistance
|
no
|
0
|
|
|
yes
|
1
|
|
ambulation
|
no
|
0
|
|
|
yes
|
1
|
|
inactivity
|
no
|
0
|
|
|
yes
|
1
|
|
unintentional weight loss
|
no
|
0
|
|
|
yes
|
1
|
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• A cutoff of >= 2 or >= 3 can be used to identify a patient who may be frail.
• An additional evaluation is needed to make the diagnosis since the PPV is low.
Performance:
• The area under the ROC curve is 0.88.
• Using >= 2 as frail: sensitivity 0.78, specificity 0.84, NPV 99.7%, PPV 10%
• Using >= 3 as frail: sensitivity 0.61, specificity 0.97, NPV 99.2%, PPV 33%
