Validity Properties of a Self-reported Modified Frailty Phenotype Among People With HIV in Clinical Care in the United States.
Stephanie A Ruderman, Allison R Webel, Amanda L Willig and 23 others
PMID 36652200WHAT IT FOUND
A four-question self-report frailty screen matched a longer screen in 522 adults with HIV and was linked with more falls, especially in those 55 and older.
It needs no grip or gait tests, but may miss some frail patients.
Key findings
01The self-reported frailty score agreed substantially with the full frailty score and used the same cut-points for not frail, prefrail, and frail.
02Among 253 participants who answered the falls question, 19% reported at least one fall, and each additional self-reported frailty component was linked with higher odds of a fall.
03The frailty-falls link was significant for participants aged 55 and older, but not significant for participants younger than 55.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis was cross-sectional, so it cannot show that frailty caused falls or that using the screen improves patient outcomes. Participants were volunteers in a nutrition and exercise study and had to be on antiretroviral therapy with an undetectable viral load, so they may be healthier than many people with HIV in care. Frailty prevalence was lower in this group than in the larger CNICS cohort, so results may not apply to sicker HIV populations. Falls were analysed only in 253 participants who answered a question added after the study started, and the study was not designed to fully evaluate falls. For some participants, the self-report and physical-function assessments were done on different days, especially during the pandemic, though most completed both within 30 days. The self-report screen may miss frail people because it was less good at identifying those classified as frail by the full screen.
Declared interests
The paper lists NIH and U.S. Public Health Service research support. No author conflicts of interest are stated in the supplied text.
The easy way to misread this
Do not conclude that this four-question screen prevents falls or improves outcomes. It was tested only as a measurement tool in people with HIV who were already in care and had suppressed viral load, and it was less good at identifying frail patients.