Screening for frailty in community-dwelling elderly subjects: Predictive validity of the modified SEGA instrument

Aims: To study the capacity of the SEGAm instrument to predict loss of independence among elderly community- dwelling subjects. Methods: The study was performed in four French departments (Ardennes, Marne, Meurthe-et-Moselle, Meuse). Subjects aged 65 years or more, living at home, who could read and understand French, with a degree of autonomy corresponding to groups 5 or 6 in the AGGIR autonomy evaluation scale were included. Assessment included demographic characteristics, comprehensive geriatric assessment, and the SEGAm instrument at baseline. Subjects had follow-up visits at home at 6 and 12 months. During follow-up, vital status and level of independence were recorded. Logistic regression was used to study predictive validity of the SEGAm instrument. Results: Among the 116 subjects with complete follow-up, 84 (72.4%) were classed as not very frail at baseline, 23 (19.8%) as frail, and 9 (7.8%) as very frail; 63 (54.3%) suffered loss of at least one ADL or IADL at 12 months. By multivariable analysis, frailty status at baseline was significantly associated with loss of independence during the 12 months of follow-up (OR= 4.52, 95% CI= 1.40-14.68; p= 0.01). We previously validated the SEGAm instrument in terms of feasibility, acceptability, internal structure validity, reliability, and discriminant validity. Conclusions: This instrument appears to be a suitable tool for screening frailty among community- dwelling elderly subjects, and could be used as a basis to plan early targeted interventions for subjects at risk of adverse outcome.