Agreement Between Performance-Based and Adult Patient Self-Report Measures for Classifying Physical Frailty
Öz
Aim: This study aimed to evaluate how far patient-reported and self-reported (PRO/SRO) items from the SF-36 physical function domain could substitute measured (PerfO) grip strength and gait speed in frailty classification, while also comparing the variability in frailty estimates produced by PerfO versus PRO/SRO approaches.
Material and Method: This study conducted a secondary analysis of two large cohorts: NuAge, representing older adults, and MACS, comprising HIV-positive and HIV-negative men. Frailty indicators of “frail walk” and “frail handgrip” were defined according to Fried’s criteria. Associations between performance-based (PerfO) and patient-/self-reported (PRO/SRO) measures were examined using correlations and stepwise logistic regression. The PRO/SRO items were further evaluated for sensitivity and specificity. Frailty status was compared using two classifications: the adapted Fried’s Frailty Phenotype (aFFP) and the Frailty Indicator Phenotype (FIP).
Results: NuAge had 1754 participants (women:914, men:840) (mean age: 4.2 ±4.1). MACS had 1151 participants (HIV- negative:679; HIV-positive:472) with complete gait speed and grip strength (mean age:56 ±5.0). The strongest predictors of frail walk were limitations in walking 200 m/several blocks and age (c-statistics: 0.71–0.87), while frail handgrip was best explained by lifting and carrying (c-statistics: 0.51–0.63). For SRO-based classifications, sensitivity ranged from 8.2% to 32.8% and specificity from 86% to 93%. In comparison, aFFP and FIP achieved markedly higher sensitivity (48%–95%) with similar specificity (86%–96%).
Conclusion: SRO measures of walking 200 m and carrying objects had poor sensitivity but high specificity, making them useful for excluding non-frail gait and grip cases. In contrast, the FIP constructed entirely from PRO/SRO items demonstrated both high sensitivity and specificity, highlighting its promise as a straightforward and practical frailty screening approach.
Anahtar Kelimeler
Rehabilitation, HIV, Aging, Frailty, Walking Speed, Grip Strength
Kaynakça
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