Operationalization of the Clinical Frailty Scale in Korean Community-Dwelling Older People

BackgroundThe Clinical Frailty Scale (CFS) is a simple measure of global fitness validated in various populations in real-world settings. In this study, we aimed to assess the characteristics and validities of the CFS in community-dwelling older people in Korea, with the original classification tree (oCFS) and a culturally modified tree (mCFS). MethodsThe comprehensive geriatric assessment records of 1,064 individuals of the Aging Study of the Pyeongchang Rural Area were used for this study. For mCFS, we considered the dependency of the food preparations and household chores not to be deficits in the male population. The frailty index was used as a reference for construct validity. We used a composite outcome of death and institutionalization for outcome validity. ResultsThe correlation coefficients with frailty index were higher in mCFS (.535) than in oCFS (.468). The mean frailty index was lower in individuals reclassified by mCFS (5 to 4) than people who stayed in mCFS 5. The classification coefficient of mCFS was significantly higher than that of oCFS (p <0.001) in determining people with frailty (frailty index.25 or higher). Trends of a higher incidence of the composite outcome were observed in both higher oCFS and mCFS, in which oCFS and mCFS did not differ significantly in predicting the risk of the outcome. ConclusionThe classification tree of CFS could be culturally adopted in a community-dwelling population of Korea and considered valid in detecting the vulnerable population.

Automated summary

This study aimed to assess the characteristics and validities of the Clinical Frailty Scale (CFS) in community-dwelling older people in Korea using the original classification tree (oCFS) and a culturally modified tree (mCFS). The results showed that the correlation coefficients with frailty index were higher in mCFS than in oCFS, and the classification coefficient of mCFS was significantly higher than that of oCFS in determining people with frailty. Therefore, the culturally modified CFS classification tree is considered valid in detecting the vulnerable population in the community-dwelling older people in Korea.