SHBC1462
S.J.LEE1, Y.R.LIM1, A.YEO2, L.ONG2, J.CHEW2, M.CHAN2, W.S.LIM2, O.BEAUCHET3
MOH Holdings Pte Ltd (MOHH)1, Tan Tock Seng Hospital2, Jewish General Hospital3
Subjective health measures are often used as frailty criteria, but the validity of self-administered online tools to identify frailty remains to be established. We aim to assess convergent, concurrent and predictive validity of the Centre of Excellence on Longevity Self-AdMinistered (CESAM) questionnaire for frailty identification in a geriatric clinic in Singapore.
We conducted cross-sectional analysis of 95 participants (mean age=80.4±6.2years) recruited consecutively from a tertiary geriatric clinic. Participants [61(64.2%)caregiver-assisted)] completed the CESAM questionnaire online, comprising 27 self-report items that encompass cognition, falls, mood and functional domains. Convergent validity was assessed using Spearman correlation with modified Barthel Index (MBI), modified version of the Chinese Mini-Mental State Examination (mCMMSE) and Geriatric Depression Scale (GDS). Concurrent validity was assessed by Area Under the Receiver Operating Characteristic curve (AUROC) against frailty [Frailty Index (FI)>/=0.25 from clinical interview and medical records]. Predictive validity for physician-diagnosed geriatric syndromes (cognitive impairment, unsteady gait with falls) and impaired proxy-rated quality-of-life [EuroQOL(EQ)-5D utility scores] were assessed using regression analyses adjusted for age and gender.
CESAM score significantly correlated with MBI (r=-0.65,P<0.001), mCMMSE (r=-0.53,P<0.001) and GDS (r=0.61,P<0.001). AUROC for CESAM was excellent for frailty [0.88(95%CI:0.81-0.95)]. Optimal CESAM cutoff of ≥ 8 for frailty (sensitivity75%;specificity82%) predicted physician-diagnosed cognitive impairment (OR3.5,95%CI:1.1-11.0), unsteady gait with falls (OR 5.3,95%CI 1.3-21.4) and lower EQ-5D (B=-0.07,95%CI:-0.09- -0.04).
We provide preliminary evidence for the validity of an online self-administered tool to identify frailty in an outpatient setting. The tool is potentially applicable to geriatricians conducting CGA remotely especially during the COVID-19 pandemic.