A Self-Reported Clinical Frailty Scale Predicts Death over a Long Time Horizon - The Manitoba Follow Up Study

Background: The Clinical Frailty Scale (CFS) is a summary measure of frailty intended to be completed after Geriatric Assessment. There are few studies on simply self-reporting the CFS (SR CFS). 

Objectives: 1. To determine if a SR CFS predicts mortality over a long time frame, and 2. To determine if the SR CFS adds prognostic information to the Frailty Index (FI). 

Methods: We analyzed data from The Manitoba Follow Up Study (MFUS), a prospective cohort study of men who qualified for air crew training during the Second World War. In 2015, we adapted the original 7 point CFS for self report (SR CFS). We then calculated a FI. We constructed Cox proportional hazards models for mortality using the FI and the SR-CFS, and compared the Harell’s C index from models with the only the SR CFS to models with both the SR CFS and the FI. Age was included in these models. 

Results: There were 121 men who were still alive, living in the community, had not been diagnosed with dementia, and for whom we could calculate both the FI and the SR CFS. Both SR CFS and the FI predicted death. The Harrell’s C Index was 0.67 for a model considering the SR CFS; compared to 0.69 for a model considering the FI and the SR CFS. Conclusions: A very simple self rated measure of frailty predicts mortality, although the added prognostic value is relatively minimal compared to the FI index alone. Clinicians and policy makers should consider the perspectives of older adults when considering definitions and measures of frailty.