McDonagh, J, Salamonson, Y, Ferguson, C, Prichard, R, Jha, SR, Macdonald, PS, Davidson, PM & Newton, PJ 2020, 'Evaluating the convergent and discriminant validity of three versions of the frailty phenotype in heart failure: results from the FRAME-HF study.', European Journal of Cardiovascular Nursing, vol. 19, no. 1.View/Download from: Publisher's site
BACKGROUND:Frailty is an important predictive measure of mortality and rehospitalisation in people with heart failure. To date, there are no frailty instruments validated for use in people with heart failure. AIM:The aim of this study was to evaluate the convergent and discriminant validity of three versions of the frailty phenotype in those with heart failure. METHODS:A single site, prospective cohort study was undertaken among individuals with a confirmed diagnosis of heart failure. Frailty was assessed concurrently using three versions of the frailty phenotype: the original frailty phenotype and two modified versions; the Survey of Health, Ageing and Retirement in Europe frailty instrument (SHARE-FI) and the St Vincent's frailty instrument. Convergent and discriminant validity were assessed by reporting the correlations between each version and related heart failure subconstructs, and by evaluating the ability of each version to discriminate between normal and abnormal scores of other physical and psychosocial scales specific to heart failure-related subconstructs. RESULTS:The New York Heart Association classes were moderately correlated with the St Vincent's frailty instrument (r=0.47, P⩽0.001), SHARE-FI (r=0.42, P⩽0.001) and the frailty phenotype (r=0.42, P⩽0.001). The SHARE-FI and the St Vincent's frailty instrument were both able to discriminate consistently between normal and abnormal scores in three out of five of the physical and psychosocial subconstructs that were assessed. The SHARE-FI was also able to discriminate between inpatients and outpatients who were classified as frail. CONCLUSIONS:Both the SHARE-FI and the St Vincent's frailty instrument displayed good convergent and discriminant validity.
McDonagh, J, Ferguson, C & Newton, PJ 2018, 'Frailty Assessment in Heart Failure: an Overview of the Multi-domain Approach', Current Heart Failure Reports, vol. 15, no. 1, pp. 17-23.View/Download from: Publisher's site
© 2018, Springer Science+Business Media, LLC, part of Springer Nature. Purpose of Review: The study aims (1) to provide a contemporary description of frailty assessment in heart failure and (2) to provide an overview of multi-domain frailty assessment in heart failure. Recent Findings: Frailty assessment is an important predictive measure for mortality and hospitalisation in individuals with heart failure. To date, there are no frailty assessment instruments validated for use in heart failure. This has resulted in significant heterogeneity between studies regarding the assessment of frailty. The most common frailty assessment instrument used in heart failure is the Frailty Phenotype which focuses on five physical domains of frailty; the appropriateness a purely physical measure of frailty in individuals with heart failure who frequently experience decreased exercise tolerance and shortness of breath is yet to be determined. A limited number of studies have approached frailty assessment using a multi-domain view which may be more clinically relevant in heart failure. Summary: There remains a lack of consensus regarding frailty assessment and an absence of a validated instrument in heart failure. Despite this, frailty continues to be assessed frequently, primarily for research purposes, using predominantly physical frailty measures. A more multidimensional view of frailty assessment using a multi-domain approach will likely be more sensitive to identifying at risk patients.
McDonagh, J, Martin, L, Ferguson, C, Jha, S, Macdonald, P, Davidson, P & Newton, P 2018, 'Frailty assessment instruments in heart failure: a systematic review.', European Journal of Cardiovascular Nursing, vol. 17, no. 1.View/Download from: Publisher's site
Frailty is an independent predictor of mortality across many conditions. Reported rates of frailty in heart failure range from 15% to 74%. There are several instruments available to assess frailty; however, to date there has been no consensus on the most appropriate instrument for use in individuals with heart failure.
To identify how frailty is assessed in individuals with heart failure and to elucidate which domains of frailty are most frequently assessed.
Key electronic databases were searched (MEDLINE, COCHRANE Central and CINAHL) to identify studies that assessed frailty in individuals with heart failure using a formal frailty instrument.
Twenty studies published in 24 articles were included, for which a total of seven unique frailty instruments were identified. The most commonly used instrument was the Frailty Phenotype (n= 11), with the majority of studies using a modified version of the Frailty Phenotype (n= 8). The second most commonly used instrument identified was the Comprehensive Geriatric Assessment (n= 4).
There is an increasing interest in the assessment of frailty, but, to date, there is no frailty instrument validated specifically in the heart failure population.
Jha, SR, McDonagh, J, Prichard, R, Newton, PJ, Hickman, LD, Fung, E, Macdonald, PS & Ferguson, C 2018, '#Frailty: A snapshot Twitter report on frailty knowledge translation.', Australasian Journal on Ageing, vol. 37, no. 4, pp. 309-312.View/Download from: Publisher's site
The objectives of this short report are to: (i) explore #Frailty Twitter activity over a six-month period; and (ii) provide a snapshot Twitter content analysis of #Frailty usage.A mixed-method study was conducted to explore Twitter data related to frailty. The primary search term was #Frailty. Objective 1: data were collected using Symplur analytics, including variables for total number of tweets, unique tweeters (users) and total number of impressions. Objective 2: a retrospectively conducted snapshot content analysis of 1500 #Frailty tweets was performed using TweetReach™ .Over a six-month period (1 January 2017-31 June 2017), there was a total of 6545 #Frailty tweets, generating 14.8 million impressions across 3986 participants. Of the 1500 tweets (814 retweets; 202 replies; 484 original tweets), 56% were relevant to clinical frailty. The main contributors ('who') were as follows: the public (29%), researchers (25%), doctors (21%), organisations (18%) and other allied health professionals (7%). Tweet main message intention ('what') was public health/advocacy (41%), social communication (28%), research-based evidence/professional education (24%), professional opinion/case studies (15%) and general news/events (7%).Twitter is increasingly being used to communicate about frailty. It is important that thought leaders contribute to the conversation. There is potential to leverage Twitter to promote and disseminate frailty-related knowledge and research.
Reported rates of frailty in individuals with heart failure range from 15-74%, accordingly, the measurement of frailty now has increasing utility in clinical and research practice.
To present the latest developments regarding frailty measurement in heart failure from a recent systematic literature review.
Key electronic databases (MEDLINE and CINAHL and the COCHRANE Central) were searched from 2001- 2016. Search terms included but not limited to 'frailty, heart failure and measurement'. Eligibility criteria consisted of; studies that included subjects with a diagnosis of heart failure and studies must have assessed frailty using a structured instrument.
From twenty-four articles there was a total of eight frailty instruments identified, the most commonly used instrument was Fried's Frailty Phenotype (n= 11). The second most common instrument was the Comprehensive Geriatric Assessment (n=6), followed by the Deficit Accumulation Index (n=2). None of the instruments have been formally validated for use in heart failure. All instruments assessed physical functioning but only four instruments assessed cognition.
There are a range of frailty instruments being utilised in heart failure. However, there is currently no frailty instruments validated for use in a heart failure specific population. Current data are limited by focusing primarily on a physical definition of frailty, future studies might look to incorporate cognitive and psychosocial domains as part of a multi-domain frailty assessment.
McDonagh, J, Martin, L, Ferguson, C, Jha, S, Macdonald, P, Davidson, P & Newton, P 2017, 'How is frailty measured in individuals with heart failure? A systematic review', The Journal of Frailty and Aging, International Conference on Frailty & Sarcopenia Research, Barcelona, Spain, pp. 152-153.
McDonagh, J, Ferguson, C, Jha, S, Ivynian, S, Crossley, C, Montgomery, E, Hwang, C, Inglis, S, Singh, G, Davidson, P, Macdonald, P & Newton, P 2016, 'Frailty in hospitalized heart failure patients predicts death and rehospitalisation at 6 months', The Journal of frailty & aging, International Conference on Frailty & Sarcopenia Research, Philadelphia, USA.