# Identification of pre-frail/frail older adults using the Integrated Care for Older People WHO Step1 screening tool: a cross sectional study

## TL;DR

This study shows that the WHO's Step1 screening tool can identify older adults at risk of pre-frailty or frailty based on mobility and nutrition alerts.

## Contribution

The study demonstrates how Step1 of the ICOPE program can effectively prioritize older adults for further care based on specific alerts.

## Key findings

- Pre-frailty/frailty was strongly associated with mobility alerts (84.7%) and nutrition alerts (88.9%).
- Combined mobility and nutrition alerts showed a 96.7% association with pre-frailty/frailty.
- For those over 76 years, psychological alerts also showed a 63.9% association with pre-frailty/frailty.

## Abstract

The Integrated Care for Older People program is a recommendation from the World Health Organization (WHO) to prevent functional decline. It is carried out in four steps, including Step1 screener, Step2 comprehensive assessment in case of anomalies detected in Step1, Step3, which is a prevention plan and Step4, involving long-term follow-up of intrinsic capacity and the implementation of the care plan. In order to meet this evaluation, need and given the constraints of healthcare professional, it is important to specify which older people are most at risk of decline (pre-frail/frail people according to Linda Fried's score).

to assess if Integrated Care for Older People WHO Step1 can segregate pre-frail/frail older adults from robust in primary care setting.

This cross-sectional study concerned participants registered on the ICOPE MONITOR platform of the Toulouse University Hospital. The results from Step1, which help identify participants most at risk of pre-frailty/frailty, were selected through regression analysis followed by a Classification and Regression Trees approach.

Between January 1, 2020, and June 30, 2024, 3,118 participants were included in this study. Pre-frailty/frailty was associated with mobility alert alone (84.7 %), nutrition alert alone (88.9 %) and with the two associated (96.7 %). For the oldest participants (over 76 years), a psychology alert was also strongly associated with pre-frailty/frailty (63.9 %).

This study allows healthcare professional to prioritize participants with impaired mobility and/or nutrition at Step1 for the next steps in Integrated Care for Older People program. This approach addresses the needs of participants by providing the appropriate response to the right clinical profile and facilitates the interpretation of Integrated Care for Older People Step1 in the community.