Psychometric Properties of Frailty Syndrome Checklist 5-Items in Frail Older Adults in Iran

Q4 Medicine
Foruzan Tavan, A. Asadollahi
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This was a cross-sectional-psychometric study which aimed at  determining the psychometric index and cut-off points of a brief checklist of 5-item FSC among Iranian adults older than 60 years old and comparing this to prior results in different countries. Results: The data were analyzed by ANOVA, multi-variable regression, confirmatory, and exploratory factor analysis, and ROC analysis via SPSS 25 and AMOS 24. The validity of the study findings was determined by internal validity, high correlation of 5 questions, confirmatory and exploratory factor analysis of 3 subdomains with a clarity value of 0.87, and high goodness of fit index (GFI). Conclusion: The determined cut-off points were compatible with those of Fried’s prior study. The designed tools used in this study evaluated frailty syndrome of the Iranian elderly in elderly rehabilitation studies with high confidence. The application of the tool would provide caregivers and policymakers with additional information as to caring for this population. \nIntroduction \nThe world population has become older due to the decreasing mortality rate, increasing life expectancy, and enhanced healthcare technologies.(1) Worldwide, the elderly population is expected to increase from 9% to 16% during 35 years from 1995 to 2030. Regionally, the elderly population is expected to increase in Asia and Iran from 9.3% to 18.6% and from 5.17 to 6.5 % over the same period, respectively.(2) Increased chronic diseases and multi-morbidity in the elderly and the associated increased prevalence of inabilities are the main concern in the growth of the elderly population . Senescence syndromes are groups of prevalent characteristics among the elderly and, as such, are not considered a disease. These syndromes are a group of prevalent characteristics among the elderly, which are not considered a disease. Frailty syndrome involves a complex combination of the natural processes of getting old with different medical problems,(3)such as weakness, dullness, decreased energy, decreased physical activity, and unintentional weight loss (in more intense cases).(3)Frailty syndrome consists of physiological disorders in six different systems (hematic, inflammatory, hormonal, obesity, neuromuscular, and nutritional).(4) The brain, endocrine, musculoskeletal, and immune systems are mostly associated with frailty syndrome, which have been studied considerably.(4) The prevalence of frailty due to its wide definition and variety of measurement tools is estimated 19.6% in Latin America and the Caribbean (5), from 3.9 per cent in China to 26% and 51.4% in India and Cuba, respectively (6), 35.7% in Brazil (7),  10% in Japan (8), and in European countries from 7.7 per cent of the Swedish elderly to 15.6% Portuguese older adults (9). There are no national frailty data in the elderly population of Iran, bBut it can be assumed to be similar to developing countries like India and Brazil. Most of the tools developed to evaluate frailty have a frailty pre-diagnosis, enabling the authorities to identify people at high risk of frailty.(10, 11) \nFrailty can be examined in both clinical and social contexts. The clinical view argues that frailty increases the risks of side effects, such as fall, hospitalization, inability, and death.(12) The social view identifies the groups in need of  additional medical care services and at high risk of dependency.(12) Policymakers and providers of health services have realized that frailty could significantly affect people, caregivers, healthcare systems, and society.(11, 12) Furthermore,  concerns have been raised regarding prevention and health management plans due to the effect of frailty on the healthcare of patients.(13) If frailty can be diagnosed, prevented, and treated by identifying its different reasons and factors, this can lead to the prevention or at least  delay in the onset of frailty syndrome. As some recent studies have suggested, frailty sequences could be reversed by implementing specific practical plans and nutritional supplements (3, 14, 15). Therefore, identification of consequences relevant to frailty is highly vital, indicating the need for a tool to predict frailty challenges in Iran. These challenges can be screened, and definite cut-off points can be determined for Iranian frail patients. These actions help the healthcare policymakers in the country to systemize and optimize their decisions, just as many developed countries have done in recent years.(16) Fried’s five-item index of frailty syndrome checklist (5-Item FSC) is one of the most applicable scales to screen frailty.(16) \nPsychometric properties and cut-off points of FSC differ from one country to another regarding their cultural, social, nutritional, and even phenotypical differences (17) compared to other indices. 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引用次数: 0

Abstract

Background: Frailty syndrome involves a complex combination of the natural process of getting old with different medical problems. Different indexes have been designed for each physical, mental, and social dimensions of frailty. Fried’s five-item index of frailty syndrome checklist is one of the most applicable scales to screen frailty. This study aimed to determine a psychometric index of frailty and the cut-off points for the Iranian elderly population. Methods: In a cross-sectional and psychpmetric study, 249 frail elderly people were selected among members of two Iranian Army Retirees Clubs in 2019. This was a cross-sectional-psychometric study which aimed at  determining the psychometric index and cut-off points of a brief checklist of 5-item FSC among Iranian adults older than 60 years old and comparing this to prior results in different countries. Results: The data were analyzed by ANOVA, multi-variable regression, confirmatory, and exploratory factor analysis, and ROC analysis via SPSS 25 and AMOS 24. The validity of the study findings was determined by internal validity, high correlation of 5 questions, confirmatory and exploratory factor analysis of 3 subdomains with a clarity value of 0.87, and high goodness of fit index (GFI). Conclusion: The determined cut-off points were compatible with those of Fried’s prior study. The designed tools used in this study evaluated frailty syndrome of the Iranian elderly in elderly rehabilitation studies with high confidence. The application of the tool would provide caregivers and policymakers with additional information as to caring for this population. Introduction The world population has become older due to the decreasing mortality rate, increasing life expectancy, and enhanced healthcare technologies.(1) Worldwide, the elderly population is expected to increase from 9% to 16% during 35 years from 1995 to 2030. Regionally, the elderly population is expected to increase in Asia and Iran from 9.3% to 18.6% and from 5.17 to 6.5 % over the same period, respectively.(2) Increased chronic diseases and multi-morbidity in the elderly and the associated increased prevalence of inabilities are the main concern in the growth of the elderly population . Senescence syndromes are groups of prevalent characteristics among the elderly and, as such, are not considered a disease. These syndromes are a group of prevalent characteristics among the elderly, which are not considered a disease. Frailty syndrome involves a complex combination of the natural processes of getting old with different medical problems,(3)such as weakness, dullness, decreased energy, decreased physical activity, and unintentional weight loss (in more intense cases).(3)Frailty syndrome consists of physiological disorders in six different systems (hematic, inflammatory, hormonal, obesity, neuromuscular, and nutritional).(4) The brain, endocrine, musculoskeletal, and immune systems are mostly associated with frailty syndrome, which have been studied considerably.(4) The prevalence of frailty due to its wide definition and variety of measurement tools is estimated 19.6% in Latin America and the Caribbean (5), from 3.9 per cent in China to 26% and 51.4% in India and Cuba, respectively (6), 35.7% in Brazil (7),  10% in Japan (8), and in European countries from 7.7 per cent of the Swedish elderly to 15.6% Portuguese older adults (9). There are no national frailty data in the elderly population of Iran, bBut it can be assumed to be similar to developing countries like India and Brazil. Most of the tools developed to evaluate frailty have a frailty pre-diagnosis, enabling the authorities to identify people at high risk of frailty.(10, 11) Frailty can be examined in both clinical and social contexts. The clinical view argues that frailty increases the risks of side effects, such as fall, hospitalization, inability, and death.(12) The social view identifies the groups in need of  additional medical care services and at high risk of dependency.(12) Policymakers and providers of health services have realized that frailty could significantly affect people, caregivers, healthcare systems, and society.(11, 12) Furthermore,  concerns have been raised regarding prevention and health management plans due to the effect of frailty on the healthcare of patients.(13) If frailty can be diagnosed, prevented, and treated by identifying its different reasons and factors, this can lead to the prevention or at least  delay in the onset of frailty syndrome. As some recent studies have suggested, frailty sequences could be reversed by implementing specific practical plans and nutritional supplements (3, 14, 15). Therefore, identification of consequences relevant to frailty is highly vital, indicating the need for a tool to predict frailty challenges in Iran. These challenges can be screened, and definite cut-off points can be determined for Iranian frail patients. These actions help the healthcare policymakers in the country to systemize and optimize their decisions, just as many developed countries have done in recent years.(16) Fried’s five-item index of frailty syndrome checklist (5-Item FSC) is one of the most applicable scales to screen frailty.(16) Psychometric properties and cut-off points of FSC differ from one country to another regarding their cultural, social, nutritional, and even phenotypical differences (17) compared to other indices. Therefore, the present study aimed to determine the validity, reliability, and cut-off points of 5-item FSC for Iranian elderly.
伊朗虚弱老年人虚弱综合征检查表5项的心理测量特性
背景:虚弱综合征涉及衰老的自然过程和不同的医疗问题的复杂组合。针对虚弱的每一个身体、心理和社会维度,都设计了不同的指数。弗里德的虚弱综合征五项指数检查表是筛查虚弱最适用的量表之一。这项研究旨在确定伊朗老年人虚弱的心理测量指数和临界点。方法:在一项横断面和心理研究中,从2019年两个伊朗陆军退休人员俱乐部的成员中选择249名体弱的老年人。这是一项横断面心理测量研究,旨在确定60岁以上伊朗成年人的5项FSC简要清单的心理测量指数和截止点,并将其与不同国家以前的结果进行比较。结果:采用方差分析、多变量回归、验证性和探索性因素分析以及SPSS 25和AMOS 24的ROC分析对数据进行分析。研究结果的有效性由内部有效性、5个问题的高度相关性、3个子域的验证性和探索性因素分析(清晰度值为0.87)以及高拟合优度指数(GFI)决定。结论:所确定的临界点与Fried之前的研究结果一致。本研究中使用的设计工具对老年康复研究中伊朗老年人的虚弱综合征进行了高度自信的评估。该工具的应用将为护理人员和政策制定者提供有关照顾这一人群的更多信息。引言由于死亡率的下降、预期寿命的延长和医疗保健技术的提高,世界人口已经老龄化。(1) 从1995年到2030年的35年间,全球老年人口预计将从9%增加到16%。从地区来看,同期亚洲和伊朗的老年人口预计将分别从9.3%增加到18.6%和从5.17%增加到6.5%。(2) 老年人慢性病和多发病率的增加以及与之相关的无能患病率的增加是老年人口增长的主要问题。衰老综合征是老年人的常见特征,因此不被视为一种疾病。这些综合征是老年人的一组普遍特征,不被认为是一种疾病。虚弱综合征涉及衰老的自然过程与不同的医疗问题的复杂组合,(3)如虚弱、迟钝、能量下降、体力活动减少和意外减肥(在更严重的情况下)。(3) 虚弱综合征包括六个不同系统的生理障碍(血液、炎症、激素、肥胖、神经肌肉和营养)。(4) 大脑、内分泌、肌肉骨骼和免疫系统大多与虚弱综合征有关,对此进行了大量研究。(4) 由于定义广泛和测量工具多样,拉丁美洲和加勒比地区的虚弱患病率估计为19.6%(5),从中国的3.9%到印度和古巴的26%和51.4%,分别为(6)、巴西的35.7%(7)、日本的10%(8),在欧洲国家,瑞典老年人的患病率从7.7%到葡萄牙老年人的15.6%(9)。没有伊朗老年人口的国家脆弱性数据,b但可以假设它与印度和巴西等发展中国家相似。大多数为评估虚弱而开发的工具都有虚弱预诊断,使当局能够识别出虚弱的高危人群。(10,11)虚弱可以在临床和社会背景下进行检查。临床观点认为,虚弱会增加副作用的风险,如跌倒、住院、无力和死亡。(12) 社会观点确定了需要额外医疗服务和高依赖风险的群体。(12) 政策制定者和医疗服务提供者已经意识到,虚弱可能会对人们、护理人员、医疗系统和社会产生重大影响。(11,12)此外,由于虚弱对患者医疗保健的影响,人们对预防和健康管理计划表示担忧。(13) 如果可以通过识别不同的原因和因素来诊断、预防和治疗虚弱,这可以预防或至少延缓虚弱综合征的发作。正如最近的一些研究所表明的那样,通过实施具体的实用计划和营养补充剂,可以逆转虚弱序列(3,14,15)。因此,识别与虚弱相关的后果至关重要,这表明需要一种工具来预测伊朗的虚弱挑战。可以对这些挑战进行筛查,并为伊朗体弱患者确定明确的分界点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of health sciences and surveillance system
Journal of health sciences and surveillance system Medicine-Medicine (miscellaneous)
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