Pilot study protocol: Developing a frailty index

Abstract

which have investigated frailty, and its determinants. The
majority of the studies available have been conducted in North
America, Mexico, and Canada. Studies within the European
Union have been sporadic and limited. These studies all focused
on profoundly frail and old participants; failing to address the
issue of understanding the full spectrum of frailty. These
countries differ to Wales with regards to financial, health and
social determinants including alcoholism, drug abuse and obesity
levels. Less developed countries suffer childhood diseases such as
diphtheria and polio, which are still prevalent causing disability.
Prevalence data specific to Wales with regard to the age and
determinants of frailty are not available. Reference [1] produced
a screening tool to determine a person’s frailty status. Typical
categories are non frail = 0 deficit, pre-frail = 1-2, deficits and
frail = 3-5 deficits [1]. The Fried screening tool is widely used to
identify physical manifestations of frailty to predict disability and
death. However, the screening tool developed by Fried [1] does
not include psychological or cognitive components [2]. More
recent research into the concept of frailty have recommended
inclusion of cognitive impairment to improve the predictive
validity of the Fried [1] screening tool for adverse health
outcomes [3]. Therefore, consensus on a universal definition and
measure remains elusive. Subsequently recommendations
highlighting the need for a frailty index to enable identification of
those who are frail have been put forward: to promote health,
well-being and subsequent healthy ageing. This pilot study will
assess process and procedure prior to the full study of which it is
anticipated will identify which determinants predict frailty, and
the domains of frailty (physical, psychological, social and
cognitive) within a sample of people over the age of 18 years in
order to develop a frailty index.
Aim: To pilot test the methods, methodologies and procedures to
gather the information needed to develop an operational frailty
index in Wales prior to applications for ethical approval for the
full study.