Frailty levels in residential aged care facilities measured using the Frailty Index and FRAIL-NH scale

Olga Theou, Edwin C.K. Tan, J. Simon Bell, Tina Emery, Leonie Robson, John E. Morley, Kenneth Rockwood, Renuka Visvanathan

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Objectives: To compare the FRAIL-NH scale with the Frailty Index in assessing frailty in residential aged care facilities. Design: Cross-sectional. Setting: Six Australian residential aged care facilities. Participants: Individuals aged 65 and older (N = 383, mean aged 87.5 ± 6.2, 77.5% female). Measurements: Frailty was assessed using the 66-item Frailty Index and the FRAIL-NH scale. Other measures examined were dementia diagnosis, level of care, resident satisfaction with care, nurse-reported resident quality of life, neuropsychiatric symptoms, and professional caregiver burden. Results: The FRAIL-NH scale was significantly associated with the Frailty Index (correlation coefficient = 0.81, P <.001). Based on the Frailty Index, 60.8% of participants were categorized as frail and 24.4% as most frail. Based on the FRAIL-NH, 37.5% of participants were classified as frail and 35.9% as most frail. Women were assessed as being frailer than men using both tools (P =.006 for FI; P =.03 for FRAIL-NH). Frailty Index levels were higher in participants aged 95 and older (0.39 ± 0.13) than in those aged younger than 85 (0.33 ± 0.13; P =.008) and in participants born outside Australia (0.38 ± 0.13) than in those born in Australia (0.34 ± 0.13; P =.01). Both frailty tools were associated with most characteristics that would indicate higher care needs, with the Frailty Index having stronger associations with all of these measures. Conclusion: The FRAIL-NH scale is a simple and practical method to screen for frailty in residential aged care facilities.

Original languageEnglish
Pages (from-to)e207-e212
Number of pages6
JournalJournal of the American Geriatrics Society
Issue number11
Publication statusPublished - 1 Nov 2016


  • aged care facilities
  • frail elderly
  • FRAIL scale
  • Frailty Index
  • long-term care
  • nursing home

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