老人老化衰弱指標臨床效度之初步測試

Objectives: As the aging population growing, early detection of frail older adults to prevent future disability care has become an important issue. This study was to establish the clinical validity of the frailty assessment tools through known groups' comparison in order to propose the feasible application for clinical practice in Taiwan. Methods: Data were collected from 2 different settings, communities and long term care facilities from northern Taiwan. The older adults were invited to complete the frailty assessment. Barthel index and instrumental activities of daily living scales were used to assess overall physical functional performance. The geriatric depression scale (GDS) and Mini Mental State Examination (MMSE) scales were used to examine subjects' psychological health. Physiological health was measured by extremity functions, vision, respiratory function, nutrition, the prevalence of urinary incontinence, and hearing. The data were compared between the two known groups to reveal the clinical validity for instruments. Results: A total of 20 older adults received the frailty assessment. The results indicated that ADL, IADL, GDS, MMSE, extremity functions except paper folding test, respiratory function, nutrition, and the prevalence of urinary incontinence had good clinical validity. Although significant difference in hearing between two groups was found, not all older adults had both hearing impairment. It is believed that hearing is not a good indicator for frailty assessment. The results of vision and motor muscle function had no significant difference in two groups which cannot provide support for the clinical validity for frailty assessment. Conclusion: These findings indicated the importance of the frailty assessment tools. Since majority of the older adults live in the community, early detecting frailty in the early stage should reduce the incidence of institution, and hospitalization.