Assessment of the Zulfiqar Frailty Scale (ZFS) in Primary Healthcare

TL;DR

This study validates the Zulfiqar Frailty Scale (ZFS) for identifying frailty in elderly individuals and compares it with another tool called mSEGA.

Contribution

The study introduces and validates the ZFS as a new tool for assessing frailty in primary healthcare settings.

Findings

Frailty prevalence was 40% using ZFS and 29% using mSEGA in a sample of 98 elderly individuals.

Age, comorbidity, polypharmacy, and functional ability were key predictors of frailty.

ZFS showed a strong correlation with mSEGA (Pearson coefficient 0.73) and a high sensitivity of 64%.

Abstract

Introduction: The primary aim of the study was to validate the Zulfiqar Frailty Scale (ZFS) and examine its concordance with the modified Short Emergency Geriatric Assessment (mSEGA) scale, Part A. Methods: A prospective observational study was conducted in Guadeloupe (France) over a two-month duration (from 20 February to 20 April 2024), involving elderly individuals aged 65 and older, deemed self-sufficient with an ADL (Activities of Daily Living) score exceeding four out of six. Results: Within this community cohort of 98 individuals, averaging 75 years in age, frailty according to the modified SEGA criteria was prevalent in 29%. Frailty according to the “ZFS” score was prevalent in 40%. Key predictors of frailty identified in our study included age, comorbidity (Charlson score), polypharmacy (total number of medications and therapeutic classes), and functional ability (ADL scores). Notably, experiences of falls and hospitalizations within the past six months significantly influenced the classification of frailty according to both ZFS and SEGA scales. Significant associations with the presence of home care aides (p < 0.0001), monopodal support test results (p < 0.0001), memory impairments (p < 0.0001), and recent hospitalizations (p = 0.0054) underscored the multidimensional impact of frailty. The Pearson correlation coefficient and its 95% confidence interval between the SEGA and Zulfiqar Frailty Scales stood at 0.73 [0.61: 0.81]. The discernment threshold for frailty was set at three out of six criteria, showcasing a sensitivity of 64% and a negative predictive value of 80%. The area under the curve (AUC) for the Zulfiqar Frailty Scale was reported as 0.8. Conclusion: The “ZFS” tool allows for the detection of frailty with a highly satisfactory sensitivity and negative predictive value.

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