Simple self-report FRAIL scale might be more closely associated with dialysis complications than other frailty screening instruments in rural chronic dialysis patients

• Published in: Nephrology (Carlton, Vic.) Vol. 20; no. 5; pp. 321 - 328
• Main Authors: Chao, Chia-Ter, Hsu, Yuan-Hsin, Chang, Pei-Yu, He, Yu-Ting, Ueng, Ruey-Shiuan, Lai, Chun-Fu, Chiang, Chih-Kang, Huang, Jenq-Wen, Huang, Sheng-Jen
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01-05-2015
• Subjects: Aged; Aged, 80 and over; Cohort Studies; dialysis; end-stage renal disease; Female; Frail Elderly; frailty; Geriatric Assessment; haemodialysis; Health Status Indicators; Humans; hypoalbuminaemia; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - therapy; Male; Middle Aged; Renal Dialysis - adverse effects; rural; Rural Health Services; Self Report; Sensitivity and Specificity; Socioeconomic Factors; dialysis; haemodialysis; frailty; end-stage renal disease; hypoalbuminaemia; rural
• ISSN: 1320-5358; 1440-1797
• DOI: 10.1111/nep.12401

Aim
Despite the perceived importance of frailty, few studies focus on its impact on rural patients undergoing chronic dialysis. Comparison of different self‐report questionnaires in assessing frailty among these patients has not been attempted before.
Methods
A prospectively enrolled chronic dialysis cohort from a rural centre was recruited for analysis. Six types of self‐report questionnaires were administered to these patients. Clinical and dialysis‐related laboratory parameters were collected. Correlation analyses between questionnaire results and dialysis complications were performed, and variables demonstrating significant correlations were entered into multivariate regression models to determine their independent associations.
Results
Six types of questionnaire (Strawbridge questionnaire, Edmonton Frail Scale, simple FRAIL scale, Groningen Frail Indicator, G8 questionnaire, and Tilburg Frail Indicator) were provided to rural patients undergoing chronic dialysis. Scores from each questionnaire showed significant association with each other, except the G8 questionnaire. Scores from the simple FRAIL scale correlated significantly with age (P = 0.02), female gender (P = 0.03), higher Liu's comorbidity index (P = 0.02), lower serum albumin (P = 0.03) and creatinine levels (P < 0.01), and higher ferritin levels (P = 0.02). The other five questionnaires did not show consistently significant relationships with important dialysis‐related complications. Multivariate linear regression analysis identified an independently negative association between serum albumin and the simple FRAIL scale results (P = 0.01).
Conclusion
This is the first study establishing the utility of different self‐report questionnaires for assessing frailty in chronic dialysis patients. The simple FRAIL scale scores might demonstrate a closer relationship with dialysis‐related complications.
Summary at a Glance
The simple FRAIL scale scores introduced in this manuscript might demonstrate a closer relationship with dialysis‐related complications. This is the first study establishing the utility of different self‐report questionnaires for assessing frailty in chronic dialysis patients.