Validation of the Pictorial Fit-Frail Scale in a memory clinic setting

Lindsay M.K. Wallace; Lisa McGarrigle; Kenneth Rockwood; Melissa K. Andrew; Olga Theou

doi:10.1017/S1041610219000905

Validation of the Pictorial Fit-Frail Scale in a memory clinic setting

Lindsay M.K. Wallace, Lisa McGarrigle, Kenneth Rockwood, Melissa K. Andrew, Olga Theou

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9 Citas (Scopus)

Resumen

Objective: To assess the feasibility, reliability, and validity of the Pictorial Fit-Frail Scale (PFFS) among patients, caregivers, nurses, and geriatricians in an outpatient memory clinic.Design: Observational study.Setting: A Canadian referral-based outpatient memory clinic.Participants: Fifty-one consecutive patients and/or their caregivers, as well as attending nurses and geriatricians.Measurements: Participants (patients, caregivers, nurses, and geriatricians) were asked to complete the PFFS based on the patient's current level of functioning. Time-to-complete and level of assistance required was recorded. Participants also completed a demographic survey and patients' medical history (including the Mini-Mental State Examination [MMSE], and Comprehensive Geriatric Assessment [CGA]) was obtained via chart review.Results: Patient participants had a mean age of 77.3±10.1 years, and average MMSE of 22.0±7.0, and 53% were female. Participants were able to complete the PFFS with minimal assistance, and their average times to completion were 4:38±2:09, 3:11±1:16, 1:05±0:19, and 0:57±0:30 (mins:sec) for patients, caregivers, nurses, and geriatricians, respectively. Mean PFFS scores as rated by patients, caregivers, nurses, and geriatricians were 9.0±5.7, 13.1±6.6, 11.2±4.5, 11.9±5.9, respectively. Patients with low MMSE scores (0-24) took significantly longer to complete the scale and had higher PFFS scores. Inter-rater reliability between nurses and geriatricians was 0.74, but it was lower when assessments were done for patients with low MMSE scores (0.47, p<0.05). The correlation between PFFS and a Frailty Index based on the CGA was moderately high and statistically significant for caregivers, nurses, and geriatricians (r=0.66, r=0.59, r=0.64, respectively), but not patients.Conclusions: The PFFS is feasible, even among people with some slight cognitive impairment, though it may be less useful when patients with severe dementia administer it to themselves. Further, the PFFS may help inform clinicians about areas of concern as identified by patients, enabling them to contribute more to diagnostic and treatment decisions or helping with health tracking and care planning.

Idioma original	English
Páginas (desde-hasta)	1063-1072
Número de páginas	10
Publicación	International Psychogeriatrics
Volumen	32
N.º	9
DOI	https://doi.org/10.1017/S1041610219000905
Estado	Published - sep. 1 2020

Nota bibliográfica

Funding Information:
LW is supported by a doctoral fellowship from the Canadian Institutes of Health Research (CIHR). LM received support from the Mitacs Elevate Program as the recipient of a postdoctoral fellowship award (IT09427). KR’s work on frailty and cognition is supported by CIHR PJT-156114, by the Dalhousie Medical Research Foundation Kathryn Allen Weldon Chair of Alzheimer Disease Research, and by the Fountain Family Innovation Fund of the Queen Elizabeth II Health Research Foundation. MKA’s work on frailty and dementia is part of a Canadian Consortium on Neurodegeneration in Aging (CCNA) investigation into how multi-morbidity modifies the risk of dementia and the patterns of disease expression (Team 14). The CCNA receives funding from the Canadian Institutes of Health Research (CNA-137794) and partner organizations ( http://www.ccna-ccnv.ca ).

Funding Information:
KR is president and chief science officer of DGI Clinical, which in the last five years has contracts with pharma and device manufacturers (Baxter, Baxalta, Shire, Hollister, Nutricia, Roche, Otsuka) on individualized outcome measurement. In 2017, he attended an advisory board meeting with Lundbeck. Otherwise, any personal fees are for invited guest lectures and academic symposia and received directly from event organizers, chiefly for presentations on frailty. He is associate director of the Canadian Consortium on Neurodegeneration in Aging, which is funded by the Canadian Institutes of Health Research, and with additional funding from the Alzheimer Society of Canada and several other charities, as well as, in its first phase (2013–2018), from Pfizer Canada and Sanofi Canada. He receives career support from the Dalhousie Medical Research Foundation as the Kathryn Allen Weldon Professor of Alzheimer Research and research support from the Canadian Institutes of Health Research, the Queen Elizabeth II Health Science Centre Foundation, the Capital Health Research Fund, and the Fountain Family Innovation Fund of the Queen Elizabeth II Health Science Centre Foundation.

Publisher Copyright:
© International Psychogeriatric Association 2019.

ASJC Scopus Subject Areas

Clinical Psychology
Gerontology
Geriatrics and Gerontology
Psychiatry and Mental health

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@article{de545d2833564d75ab29b7218ce17859,

title = "Validation of the Pictorial Fit-Frail Scale in a memory clinic setting",

abstract = "Objective: To assess the feasibility, reliability, and validity of the Pictorial Fit-Frail Scale (PFFS) among patients, caregivers, nurses, and geriatricians in an outpatient memory clinic.Design: Observational study.Setting: A Canadian referral-based outpatient memory clinic.Participants: Fifty-one consecutive patients and/or their caregivers, as well as attending nurses and geriatricians.Measurements: Participants (patients, caregivers, nurses, and geriatricians) were asked to complete the PFFS based on the patient's current level of functioning. Time-to-complete and level of assistance required was recorded. Participants also completed a demographic survey and patients' medical history (including the Mini-Mental State Examination [MMSE], and Comprehensive Geriatric Assessment [CGA]) was obtained via chart review.Results: Patient participants had a mean age of 77.3±10.1 years, and average MMSE of 22.0±7.0, and 53% were female. Participants were able to complete the PFFS with minimal assistance, and their average times to completion were 4:38±2:09, 3:11±1:16, 1:05±0:19, and 0:57±0:30 (mins:sec) for patients, caregivers, nurses, and geriatricians, respectively. Mean PFFS scores as rated by patients, caregivers, nurses, and geriatricians were 9.0±5.7, 13.1±6.6, 11.2±4.5, 11.9±5.9, respectively. Patients with low MMSE scores (0-24) took significantly longer to complete the scale and had higher PFFS scores. Inter-rater reliability between nurses and geriatricians was 0.74, but it was lower when assessments were done for patients with low MMSE scores (0.47, p<0.05). The correlation between PFFS and a Frailty Index based on the CGA was moderately high and statistically significant for caregivers, nurses, and geriatricians (r=0.66, r=0.59, r=0.64, respectively), but not patients.Conclusions: The PFFS is feasible, even among people with some slight cognitive impairment, though it may be less useful when patients with severe dementia administer it to themselves. Further, the PFFS may help inform clinicians about areas of concern as identified by patients, enabling them to contribute more to diagnostic and treatment decisions or helping with health tracking and care planning. ",

author = "Wallace, {Lindsay M.K.} and Lisa McGarrigle and Kenneth Rockwood and Andrew, {Melissa K.} and Olga Theou",

note = "Funding Information: LW is supported by a doctoral fellowship from the Canadian Institutes of Health Research (CIHR). LM received support from the Mitacs Elevate Program as the recipient of a postdoctoral fellowship award (IT09427). KR{\textquoteright}s work on frailty and cognition is supported by CIHR PJT-156114, by the Dalhousie Medical Research Foundation Kathryn Allen Weldon Chair of Alzheimer Disease Research, and by the Fountain Family Innovation Fund of the Queen Elizabeth II Health Research Foundation. MKA{\textquoteright}s work on frailty and dementia is part of a Canadian Consortium on Neurodegeneration in Aging (CCNA) investigation into how multi-morbidity modifies the risk of dementia and the patterns of disease expression (Team 14). The CCNA receives funding from the Canadian Institutes of Health Research (CNA-137794) and partner organizations ( http://www.ccna-ccnv.ca ). Funding Information: KR is president and chief science officer of DGI Clinical, which in the last five years has contracts with pharma and device manufacturers (Baxter, Baxalta, Shire, Hollister, Nutricia, Roche, Otsuka) on individualized outcome measurement. In 2017, he attended an advisory board meeting with Lundbeck. Otherwise, any personal fees are for invited guest lectures and academic symposia and received directly from event organizers, chiefly for presentations on frailty. He is associate director of the Canadian Consortium on Neurodegeneration in Aging, which is funded by the Canadian Institutes of Health Research, and with additional funding from the Alzheimer Society of Canada and several other charities, as well as, in its first phase (2013–2018), from Pfizer Canada and Sanofi Canada. He receives career support from the Dalhousie Medical Research Foundation as the Kathryn Allen Weldon Professor of Alzheimer Research and research support from the Canadian Institutes of Health Research, the Queen Elizabeth II Health Science Centre Foundation, the Capital Health Research Fund, and the Fountain Family Innovation Fund of the Queen Elizabeth II Health Science Centre Foundation. Publisher Copyright: {\textcopyright} International Psychogeriatric Association 2019.",

year = "2020",

month = sep,

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doi = "10.1017/S1041610219000905",

language = "English",

volume = "32",

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T1 - Validation of the Pictorial Fit-Frail Scale in a memory clinic setting

AU - Wallace, Lindsay M.K.

AU - McGarrigle, Lisa

AU - Rockwood, Kenneth

AU - Andrew, Melissa K.

AU - Theou, Olga

N1 - Funding Information: LW is supported by a doctoral fellowship from the Canadian Institutes of Health Research (CIHR). LM received support from the Mitacs Elevate Program as the recipient of a postdoctoral fellowship award (IT09427). KR’s work on frailty and cognition is supported by CIHR PJT-156114, by the Dalhousie Medical Research Foundation Kathryn Allen Weldon Chair of Alzheimer Disease Research, and by the Fountain Family Innovation Fund of the Queen Elizabeth II Health Research Foundation. MKA’s work on frailty and dementia is part of a Canadian Consortium on Neurodegeneration in Aging (CCNA) investigation into how multi-morbidity modifies the risk of dementia and the patterns of disease expression (Team 14). The CCNA receives funding from the Canadian Institutes of Health Research (CNA-137794) and partner organizations ( http://www.ccna-ccnv.ca ). Funding Information: KR is president and chief science officer of DGI Clinical, which in the last five years has contracts with pharma and device manufacturers (Baxter, Baxalta, Shire, Hollister, Nutricia, Roche, Otsuka) on individualized outcome measurement. In 2017, he attended an advisory board meeting with Lundbeck. Otherwise, any personal fees are for invited guest lectures and academic symposia and received directly from event organizers, chiefly for presentations on frailty. He is associate director of the Canadian Consortium on Neurodegeneration in Aging, which is funded by the Canadian Institutes of Health Research, and with additional funding from the Alzheimer Society of Canada and several other charities, as well as, in its first phase (2013–2018), from Pfizer Canada and Sanofi Canada. He receives career support from the Dalhousie Medical Research Foundation as the Kathryn Allen Weldon Professor of Alzheimer Research and research support from the Canadian Institutes of Health Research, the Queen Elizabeth II Health Science Centre Foundation, the Capital Health Research Fund, and the Fountain Family Innovation Fund of the Queen Elizabeth II Health Science Centre Foundation. Publisher Copyright: © International Psychogeriatric Association 2019.

PY - 2020/9/1

Y1 - 2020/9/1

N2 - Objective: To assess the feasibility, reliability, and validity of the Pictorial Fit-Frail Scale (PFFS) among patients, caregivers, nurses, and geriatricians in an outpatient memory clinic.Design: Observational study.Setting: A Canadian referral-based outpatient memory clinic.Participants: Fifty-one consecutive patients and/or their caregivers, as well as attending nurses and geriatricians.Measurements: Participants (patients, caregivers, nurses, and geriatricians) were asked to complete the PFFS based on the patient's current level of functioning. Time-to-complete and level of assistance required was recorded. Participants also completed a demographic survey and patients' medical history (including the Mini-Mental State Examination [MMSE], and Comprehensive Geriatric Assessment [CGA]) was obtained via chart review.Results: Patient participants had a mean age of 77.3±10.1 years, and average MMSE of 22.0±7.0, and 53% were female. Participants were able to complete the PFFS with minimal assistance, and their average times to completion were 4:38±2:09, 3:11±1:16, 1:05±0:19, and 0:57±0:30 (mins:sec) for patients, caregivers, nurses, and geriatricians, respectively. Mean PFFS scores as rated by patients, caregivers, nurses, and geriatricians were 9.0±5.7, 13.1±6.6, 11.2±4.5, 11.9±5.9, respectively. Patients with low MMSE scores (0-24) took significantly longer to complete the scale and had higher PFFS scores. Inter-rater reliability between nurses and geriatricians was 0.74, but it was lower when assessments were done for patients with low MMSE scores (0.47, p<0.05). The correlation between PFFS and a Frailty Index based on the CGA was moderately high and statistically significant for caregivers, nurses, and geriatricians (r=0.66, r=0.59, r=0.64, respectively), but not patients.Conclusions: The PFFS is feasible, even among people with some slight cognitive impairment, though it may be less useful when patients with severe dementia administer it to themselves. Further, the PFFS may help inform clinicians about areas of concern as identified by patients, enabling them to contribute more to diagnostic and treatment decisions or helping with health tracking and care planning.

AB - Objective: To assess the feasibility, reliability, and validity of the Pictorial Fit-Frail Scale (PFFS) among patients, caregivers, nurses, and geriatricians in an outpatient memory clinic.Design: Observational study.Setting: A Canadian referral-based outpatient memory clinic.Participants: Fifty-one consecutive patients and/or their caregivers, as well as attending nurses and geriatricians.Measurements: Participants (patients, caregivers, nurses, and geriatricians) were asked to complete the PFFS based on the patient's current level of functioning. Time-to-complete and level of assistance required was recorded. Participants also completed a demographic survey and patients' medical history (including the Mini-Mental State Examination [MMSE], and Comprehensive Geriatric Assessment [CGA]) was obtained via chart review.Results: Patient participants had a mean age of 77.3±10.1 years, and average MMSE of 22.0±7.0, and 53% were female. Participants were able to complete the PFFS with minimal assistance, and their average times to completion were 4:38±2:09, 3:11±1:16, 1:05±0:19, and 0:57±0:30 (mins:sec) for patients, caregivers, nurses, and geriatricians, respectively. Mean PFFS scores as rated by patients, caregivers, nurses, and geriatricians were 9.0±5.7, 13.1±6.6, 11.2±4.5, 11.9±5.9, respectively. Patients with low MMSE scores (0-24) took significantly longer to complete the scale and had higher PFFS scores. Inter-rater reliability between nurses and geriatricians was 0.74, but it was lower when assessments were done for patients with low MMSE scores (0.47, p<0.05). The correlation between PFFS and a Frailty Index based on the CGA was moderately high and statistically significant for caregivers, nurses, and geriatricians (r=0.66, r=0.59, r=0.64, respectively), but not patients.Conclusions: The PFFS is feasible, even among people with some slight cognitive impairment, though it may be less useful when patients with severe dementia administer it to themselves. Further, the PFFS may help inform clinicians about areas of concern as identified by patients, enabling them to contribute more to diagnostic and treatment decisions or helping with health tracking and care planning.

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Validation of the Pictorial Fit-Frail Scale in a memory clinic setting

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