Ann Geriatr Med Res.  2020 Jun;24(2):125-138. 10.4235/agmr.20.0021.

Development of Korean Frailty Index for Primary Care (KFI-PC) and Its Criterion Validity

Affiliations
  • 1Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
  • 2Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea
  • 3Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
  • 4Graduate School of Social Welfare, Yonsei University, Seoul, Korea
  • 5Department of Biomedical Science and Technology, East-West Medical Research Institute, College of Medicine, Kyung Hee University, Seoul, Korea

Abstract

Background
The objective of this study was to develop and validate the Korean Frailty Index for Primary Care (KFI-PC) based on a comprehensive geriatric assessment.
Methods
We developed a 53-item KFI-PC comprising 10 standard domains: cognitive status including delirium or dementia; mood; communication including vision, hearing, and speech; mobility; balance; bowel function; bladder function; ability to carry out activities of daily living; nutrition; and social resources. To test its validity, we applied KFI-PC to participants of the Korean Frailty Aging and Cohort Study (KFACS). We analyzed 1,242 participants (mean age, 77.9±3.9 years; 47.2% men) from the KFACS who visited 10 study centers in 2018, after excluding 32 participants with missing data required to assess Fried’s physical frailty phenotype.
Results
The mean KFI-PC score was 0.17±0.08, ranging from 0.02 to 0.52. The median KFI-PC score was higher in women than in men, and there was a trend toward higher values in older age groups. The prevalence of frailty when applying a generally used frailty index cutoff point of >0.25 was 17.5% in the whole study sample. As a construct validation of KFI-PC, the area under the receiver operating characteristic curve for Fried’s physical frailty was 0.921, and the optimal cutoff value to predict frailty phenotype was 0.23. The KFI-PC score also correlated well with physical, cognitive, and psychological functions; nutritional status; disability in activities of daily living; and instrumental activities of daily living. The Cronbach alpha coefficient of the 54 total items was 0.737.
Conclusion
We developed KFI-PC with 53 deficits, including comprehensive geriatric assessment components, and demonstrated the acceptable construct validity and internal consistency of KFI-PC.

Keyword

Frailty; Validity; Comprehensive geriatric assessment
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