Feasibility,reliability,validity of an electronic Frailty Index based on Comprehensive Geriatric Assessment in Primary Care

Method : We enrolled community-dwelling older adults with mild/moderate frailty under the care of Fraser Health and Nova Scotia Health (n=100). A PCP and a geriatrician assessed each patient independently at baseline and six months. PCP and geriatrician inter-rater agreements were tested using the intraclass correlation coefficient (ICC). The eFI-CGA characteristics were also examined

Results: Ninety-eight percent of the participants completed both PCP and geriatrician assessments at baseline (84 years, 62% women, 59% married currently). The mean eFI-CGA was 0.28±0.11 and 0.29±0.12, which changed insignificantly at follow-up 82% of patients also completed (0.28 ± 0.12 and 0.28 ±0.12). The eFI-CGA scores were correlated (each p<.001) with the Clinical Frailty Scale (CFS) at baseline and follow-up (r≥0.61 by PCP, r?0.70 by geriatrician) and with age (r≥0.44 by PCP, r≥0.45 by geriatrician). The ICC value for the eFI-CGA by PCP and geriatrician was 0.91 at baseline and 0.87 at follow-up, higher than that for CFS (0.76; each p<.001).

Discussion: The frailty assessments based on eCGA by PCP and geriatricians were highly comparable, suggesting that it is reliable and feasible to assess frailty in primary care using eFI-CGA.

Conclusion: The study supports the role of eFI-CGA in geriatrilizing primary care for early assessment and management of frailty. Further research will scale up the eFI-CGA implementation and application.