Screening for Frailty/Pre-Frailty and Low Muscle Mass in older adults using Diagnostic Accuracy measures and Regression Tree
Screening for Frailty/Pre-Frailty and Low Muscle Mass in older adults using Diagnostic Accuracy measures and Regression Tree
Introduction: Frailty is a biological syndrome characterized by an increase in physical and psychological vulnerability and reduced functionality, resistance to stressors, physiological reserves and intrinsic capacity of an individual. Frailty is widely associated with decreased body muscle mass, which has physical and social consequences for the older adults. The use of low-cost and easily applicable instruments and models for screening for frailty and low muscle mass in the older adults is feasible in primary health care, since their diagnoses are complex and require the use of high-cost technologies. Objective: To identify a practical tool to enable screening for frailty/pre-frailty and develop a simple model for low muscle mass screening in older adults. Methods: This is a cross-sectional study composed of 786 community-dwelling older adults residents in Parnamirim (Rio Grande do Norte), aged 60 or over. Sociodemographic, anthropometric, body composition and physical performance data were assessed. Short Physical Performance Battery (SPPB) diagnostic accuracy was evaluated for frailty and pre-frailty screening. For the screening of low muscle mass, analyzes were performed with a Regression Tree to identify a model. Results: SPPB has good diagnostic accuracy to discriminate between non-frail and frail older adults using a cut-off point of ≤9 points. For the identification of pre-frailty, SPPB presented measures of diagnostic accuracy from low to moderate, however, it was verified that this instrument can help in screening pre-frail older adults from the cut-off point of ≤11 points in total SPPB score. For the screening of low muscle mass, a model was developed using a Regression Tree composed of variables such as gender, body mass index, calf circumference and use of psychotropic drugs.