The SHARE frailty instrument for primary care predicts incident disability in a European population-based sample.

BACKGROUND: The adoption of a frailty paradigm in primary care would be helpful to identify adults who need priority access to specialised resources. The frailty phenotype by Fried et al is a popular operationalisation of frailty, but it is not easily applicable in routine primary care practice. We recently created and validated a frailty instrument based on the Survey of Health, Ageing and Retirement in Europe (SHARE-FI), in order to provide primary care practitioners with an easy, reliable and freely accessible tool for the assessment and monitoring of frailty in community dwelling adults over the age of 50 years (www.biomedcentral.com/1471-2318/10/57).

AIM: To provide further prospective validation of SHARE-FI, with a focus on disability.

DESIGN: longitudinal study (wave 1: 2004-2006; mean follow-up: 2.4 years).

SETTING: European population-based survey (12 countries).

SUBJECTS: 17 567 community dwelling participants (mean age 63.3 years), of whom 13 378 (76.2%) were non-frail, 3438 (19.6%) pre-frail and 751 (4.3%) frail.

MAIN OUTCOME MEASURES: number of difficulties with basic (ADL) and instrumental (IADL) activities of daily living.

STATISTICAL ANALYSES: repeated measures ANOVA with adjustment for baseline age.

RESULTS: By wave 2, 3.6% of the non-frail, 12.2% of the pre-frail and 30.4% of the frail had increased their number of ADL difficulties by at least one. Likewise, 6.6% of the non-frail, 20.4% of the prefrail and 36.6% of the frail had, by wave 2, increased their number of IADL difficulties by at least one. Table 1 shows the repeated measures ANOVA suggested.

CONCLUSION: SHARE-FI may contribute to quality in primary care by offering a quick and reliable way to assess and monitor frailty in community dwelling individuals over the age of 50 and prioritize their access to resources, and it serves as a novel tool for audit and research.