Edmonton Kırılganlık Ölçeği’nin Türkiye’de Toplumda Yaşayan Yaşlı Yetişkinlerde Geçerlik ve Güvenirliği

Yıl 2024, Cilt: 10 Sayı: 2, 344 - 350, 01.05.2024

Serdar Ceylan , Merve Güner , Arzu Okyar Baş , Burcu Balam Doğu , Meltem Gülhan Halil , Mustafa Cankurtaran , Cafer Balcı

https://doi.org/10.53394/akd.1295329

Öz

Amaç: Çalışmada Edmonton Kırılganlık Ölçeği’nin (EKÖ) Türkiye’de toplumda yaşayan yaşlı yetişkinlerde geçerlik ve güvenirliğinin gösterilmesi amaçlandı.
Yöntem: Bir ünivesite hastanesi geriatri polikliniğine başvuran katılımcılar dahil edildi. Edmonton Kırılganlık Ölçeği’nin geçerliği Klinik Kırılganlık Skalası (KKS) ile uyumu ile test edildi.
Bulgular: Ortanca EKÖ skoru 4.0 (Çeyrekler arası aralık (ÇAA): 2.0-7.0) ve ortanca KKS skoru 3.0 (ÇAA: 3.0-4.0) idi. Edmonton Kırılganlık Ölçeği ile KKS arasında önemli derecede uyum vardı (Cohen's kappa: 0.715, p<0.001). Edmonton Kırılganlık Ölçeği’nin gözlemciler arası ve test-tekrar test güvenirlikleri mükemmeldi (Cohen's kappa: 0.846, p<0.001; Cohen's kappa: 1.0, p<0.001, sırasıyla). Referans ölçeğe göre hesaplanan değerlerde, EKÖ’nün seçiciliği %100.0, duyarlılığı %62.96 olarak saptandı.
Sonuç: Edmonton Kırılganlık Ölçeği, toplumda yaşayan yaşlı yetişkinlerde geçerli ve güvenilirdir. Klinikte yaygın olarak kullanımı olumsuz sağlık sonuçlarının öngörülmesine ve zamanında müdahelelerin yapılmasına yardımcı olabilir.

Anahtar Kelimeler

Yaşlı, kırılganlık, geriatrik değerlendirme

Validation and Reliability of Edmonton Frail Scale In Community - Dwelling Older Adults in Türkiye

Öz

Objectives: This study aimed to demonstrate the validity and reliability of the Edmonton Frail Scale (EFS) among community-dwelling older adults in Türkiye.
Methods: Participants who applied to the geriatrics outpatient clinic of a university hospital were included. The validity of the EFS was tested by its concordance with the Clinical Frailty Scale (CFS).
Results: The median EFS score was 4.0 (IQR: 2.0-7.0), and the median CFS score was 3.0 (IQR: 3.0-4.0). There was substantial concordance between EFS and CFS (Cohen's kappa: 0.715, p<0.001). Furthermore, the EFS inter-rater and retest reliability values were excellent (Cohen's kappa: 0.846, p<0.001; Cohen's kappa: 1.0, p<0.001, respectively). Calculated based on the reference scale, the EFS specificity was 100.0%, and the sensitivity was 62.96%.
Conclusion: The EFS is a valid and reliable scale for assessing frailty in community-dwelling older adults. Its widespread clinical use can help predict adverse health outcomes and enable timely interventions.

Anahtar Kelimeler

Aged, frailty, geriatric assessment

Kaynakça

• 1. Beard JR, Officer A, de Carvalho IA, Sadana R, Pot AM, Michel JP, Lloyd-Sherlock P, Epping-Jordan JE, Peeters G, Mahanani WR, Thiyagarajan JA, Chatterji S. The World report on ageing and health: a policy framework for healthy ageing. Lancet 2016; 387(10033):2145-54.
• 2. De Lepeleire J, Iliffe S, Mann E, Degryse JM. Frailty: an emerging concept for general practice. Br J Gen Pract 2009; 59(562):e177-82.
• 3. Schuurmans H, Steverink N, Lindenberg S, Frieswijk N, Slaets JP. Old or frail: what tells us more? J Gerontol A Biol Sci Med Sci 2004; 59(9):M962-5.
• 4. Vermeiren S, Vella-Azzopardi R, Beckwée D, Habbig AK, Scafoglieri A, Jansen B, Bautmans I. Frailty and the Prediction of Negative Health Outcomes: A Meta-Analysis. J Am Med Dir Ass 2016; 17(12):1163.e1-e17.
• 5. Chu W, Chang SF, Ho HY. Adverse Health Effects of Frailty: Systematic Review and Meta-Analysis of Middle-Aged and Older Adults With Implications for Evidence-Based Practice. Worldviews Evid Based Nurs 2021; 18(4):282-9.
• 6. Hoogendijk EO, Afilalo J, Ensrud KE, Kowal P, Onder G, Fried LP. Frailty: implications for clinical practice and public health. Lancet 2019; 394(10206):1365-75.
• 7. Aguayo GA, Donneau A-F, Vaillant MT, Schritz A, Franco OH, Stranges S, Malisoux L, Guillaume M, Witte DR. Agreement Between 35 Published Frailty Scores in the General Population. Am J Epidemiol 2017; 186(4):420-34.
• 8. Dent E, Kowal P, Hoogendijk EO. Frailty measurement in research and clinical practice: A review. Eur J Intern Med 2016; 31:3-10.
• 9. Rolfson DB, Majumdar SR, Tsuyuki RT, Tahir A, Rockwood K. Validity and reliability of the Edmonton Frail Scale. Age Ageing 2006; 35(5):526-9.
• 10. Faller JW, Pereira DDN, de Souza S, Nampo FK, Orlandi FS, Matumoto S. Instruments for the detection of frailty syndrome in older adults: A systematic review. PloS One 2019; 14(4):e0216166.
• 11. Ramírez Ramírez JU, Cadena Sanabria MO, Ochoa ME. Edmonton Frail Scale in Colombian older people. Comparison with the Fried criteria. Rev Esp Geriatr Gerontol 2017; 52(6):322-5.
• 12. Yang L, Jiang Y, Xu S, Bao L, Parker D, Xu X, Li J. Evaluation of frailty status among older people living in urban communities by Edmonton Frail Scale in Wuhu, China: a cross-sectional study. Contemp Nurse 2018; 54(6):630-9.
• 13. Fabrício-Wehbe SC, Schiaveto FV, Vendrusculo TR, Haas VJ, Dantas RA, Rodrigues RA. Cross-cultural adaptation and validity of the 'Edmonton Frail Scale - EFS' in a Brazilian elderly sample. Rev Lat Am Enfermagem 2009; 17(6):1043-9.
• 14. Johnston MC, Crilly M, Black C, Prescott GJ, Mercer SW. Defining and measuring multimorbidity: a systematic review of systematic reviews. Eur J Public Health 2019; 29(1):182-9.
• 15. Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatr 2017; 17(1):230.
• 16. Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, Erikson P. Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. Value Health 2005; 8(2):94-104.
• 17. Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, Mitnitski A. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005; 173(5):489-95.
• 18. Özsürekci C, Balcı C, Kızılarslanoğlu MC, Çalışkan H, Tuna Doğrul R, Ayçiçek G, Sümer F, Karabulut E, Yavuz BB, Cankurtaran M, Halil MG. An important problem in an aging country: identifying the frailty via 9 Point Clinical Frailty Scale. Acta Clin Belg 2020; 75(3):200-4.
• 19. Flack VF, Afifi AA, Lachenbruch PA, Schouten HJA. Sample size determinations for the two rater kappa statistic. Psychometrika 1988; 53(3):321-5.
• 20. Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc 2012; 60(8):1487-92.
• 21. O’Caoimh R, Sezgin D, O’Donovan MR, Molloy DW, Clegg A, Rockwood K, Liew A. Prevalence of frailty in 62 countries across the world: a systematic review and meta-analysis of population-level studies. Age Ageing 2020; 50(1):96-104.
• 22. Gagesch M, Chocano-Bedoya PO, Abderhalden LA, Freystaetter G, Sadlon A, Kanis JA, Kressig RW, Guyonnet S, DaSilva JAP, Felsenberg D, Rizzoli R, Blauth M, Orav EJ, Egli A, Bischoff-Ferrari HA. Prevalence of Physical Frailty: Results from the DO-HEALTH Study. J Frailty Aging 2022; 11(1):18-25.
• 23. Aygör HE, Fadıloğlu Ç, Şahin S, Aykar F, Akçiçek F. Validation of Edmonton Frail Scale into Elderly Turkish Population. Arch Gerontol Geriatr 2018; 76:133-7.
• 24. He Y, Li LW, Hao Y, Sim EY, Ng KL, Lee R, Lim MS, Poopalalingam R, Abdullah HR. Assessment of predictive validity and feasibility of Edmonton Frail Scale in identifying postoperative complications among elderly patients: a prospective observational study. Sci Rep 2020; 10(1):14682.
• 25. Varan HD, Kilic MK, Kizilarslanoglu MC, Dogrul RT, Arik G, Kara O, Guner G, Aycicek GS, Can B, Halil M. Frailty and its Correlates in Older Adults: A Challenging and Preventable Geriatric Syndrome. Erciyes Medical Journal 2020; 42(2):150-7.
• 26. Won CW, Kim S. Use of Frailty in Deciding Clinical Treatment Goals for Chronic Disease in Elderly Patients in the Community. J Am Med Direct Ass 2016; 17(11):967-9.
• 27. Cesari M, Calvani R, Marzetti E. Frailty in Older Persons. Clin Geriatr Med 2017; 33(3):293-303.
• 28. Dent E, Kowal P, Hoogendijk EO. Frailty measurement in research and clinical practice: A review. Eur J Intern Med 2016; 31:3-10.
• 29. Bautista L, DiDonato RM, Bennett KP, Bautista M. The Edmonton Frail Scale as a preoperative assessment tool in elective outpatient surgery. Can J Anaesth 2021; 68(6):925-7.
• 30. Graham MM, Galbraith PD, O'Neill D, Rolfson DB, Dando C, Norris CM. Frailty and outcome in elderly patients with acute coronary syndrome. Can J Cardiol 2013; 29(12):1610-5.
• 31. Partridge JS, Fuller M, Harari D, Taylor PR, Martin FC, Dhesi JK. Frailty and poor functional status are common in arterial vascular surgical patients and affect postoperative outcomes. Int J Surg 2015; 18:57-63.
• 32. Lang PO, Michel JP, Zekry D. Frailty syndrome: a transitional state in a dynamic process. Gerontol 2009; 55(5):539-49.
• 33. Xie B, Larson JL, Gonzalez R, Pressler SJ, Lustig C, Arslanian-Engoren C. Components and Indicators of Frailty Measures: A Literature Review. J Frailty Aging 2017; 6(2):76-82.
• 34. Eyigor S, Kutsal YG, Duran E, Huner B, Paker N, Durmus B, Sahin N, Civelek GM, Gokkaya K, Doğan A, Günaydın R, Toraman F, Cakir T, Evcik D, Aydeniz A, Yildirim AG, Borman P, Okumus M, Ceceli E. Frailty prevalence and related factors in the older adult-FrailTURK Project. Age 2015; 37(3):9791.
• 35. Tuna Doğrul R, Doğan Varan H, Kizilarslanoğlu MC, Kiliç MK, Kara Ö, Arik G, Halil M, Cankurtaran M, Doğu BB. Association of physical frailty with cognitive function and mood in older adults without dementia and depression. Turk J Med Sci 2021; 51(5):2334-40.
• 36. Akyol Guner T. Evaluation of frailty, abuse and depression among community-dwelling older adults in a nortwest city of Turkey. Psychogeriatr 2022; 22(4):485-92.
• 37. Naharci MI, Tasci I. Frailty status and increased risk for falls: The role of anticholinergic burden. Arch Gerontol Geriatr 2020; 90:104136.
• 38. Okyar Baş A, Güner Oytun M, Kahyaoğlu Z, Çöteli S, Ceylan S, Boğa İ, Doğu BB, Cankurtaran M, Halil MG. Orthostatic intolerance: a frailty marker for older adults. Eur Geriatr Med 2022; 13(3):675-84.