Nico De Witte, Lieve Hoeyberghs, Emily Verte, Liesbeth De Donder, Eva Dierckx, Dominique Verte, G.I.J.M Kempen, Jos M.G.A Schols
Background: In an ageing society, the concept of frailty in older persons is a fast growing research area in gerontology and geriatric medicine. Some researchers consider frailty as a clinical, pure biomedical or physical problem. Other scholars suggest to give more attention to the psychological aspects of frailty because conceptualizing frailty as a pure medical problem is neglecting both the capacities of older people themselves to withstand stress and their experiences. In response to this, the Comprehensive Frailty Assessment Instrument was developed and assesses physical, psychological, social and environmental frailty. Although the CFAI is validated and captures four domains of frailty, the lack of cut-offs hampered the use of the instrument in practice. Therefore, the aim is to develop cut-offs for each frailty domain and to assess their construct validity.
Methods: Two-step cluster analysis on a dataset of 33629 community dwelling older people in Belgium.
Results: Cut-offs for the total score on frailty and the four domains were developed. In order to assess construct validity, these groups were subsequently analysed with variables for which there is evidence in literature for their association with frail. The developed cut-offs are in line with previous findings, pointing towards construct validity of the cut-offs.
Conclusion: This study provides support for the use of the CFAI and its cut-offs in order to detect community dwelling older people.