Feasibility and Factor Structure of the FRAIL Scale in Older Adults.
OBJECTIVES
The aim of the present study was to (1) evaluate a geriatric outpatient sample with the FRAIL scale; (2) investigate the psychometric properties of the scale; and (3) characterize different associations of the subdimensions of the scale with demographic and clinical data.


DESIGN
Cross-sectional observational study.


SETTING
Geriatric outpatient center a university-based hospital in São Paulo, Brazil.


PARTICIPANTS
A total of 811 men and women aged 60 years or older evaluated between March 2015 and September 2015.


MEASUREMENTS
A translated version of the FRAIL scale was used to evaluate frailty. A review of sociodemographic data, medical records, medication, and laboratory data was conducted. A multivariate ordinal logistic regression model was used to investigate the association between frailty categories and clinical variables. Exploratory factor analysis and 2-parameter logistic item response theory was used to evaluate the psychometric properties of the FRAIL scale.


RESULTS
The sample was distributed as 13.6% robust, 48.7% prefrail, and 37.7% frail older adults. Most participants reported fatigue (72.3%). Frailty was associated with older age (P = .02), depression (P = .02), dementia (P < .001), and number of medications taken (P < .001). A 2-factor model of the FRAIL scale ("ambulation" and "resistance" namely physical performance; "fatigue," "weight loss," and "illnesses" namely health status) provided independent classifications of frailty status. Physical performance (ambulation and resistance) was strongly associated with higher age and dementia, whereas health status (fatigue, weight loss, and illnesses) was more associated with female sex and depression.


CONCLUSIONS
Our results suggest the existence of 2 subdimensions of the scale, suggesting different pathways to frailty. Frailty was associated with older age, depression, dementia, and number of medications in this outpatient sample.
['Aprahamian|Ivan|I|', 'Lin|Sumika Mori|SM|', 'Suemoto|Claudia Kimie|CK|', 'Apolinario|Daniel|D|', 'Oiring de Castro Cezar|Natália|N|', 'Elmadjian|Serpui Marie|SM|', 'Filho|Wilson Jacob|WJ|', 'Yassuda|Mônica Sanches|MS|']
D000368:Aged D000369:Aged, 80 and over D001938:Brazil D003430:Cross-Sectional Studies D005240:Feasibility Studies D005260:Female D016330:Frail Elderly D000073496:Frailty D015577:Geriatric Assessment D006801:Humans D008297:Male D011795:Surveys and Questionnaires
Frailty physical performance geriatric assessment multimorbidities