Background/Objectives: To investigate the predictive validity of the short, simple FRAIL-NH frailty screening tool in the long term care population and to then compare the predictive validity with the frailty index (FI) for 6-month adverse health outcomes. Design: Retrospective study using the Minimum Data Set (MDS) 3.0 and chart review from June-December 2014. Setting: Two Long Term Care Facilities in Saint Louis, MO. Participants: 270 patients ages >= 65 years old residing in long term care. Measurements: Frailty was measured using the FRAIL-NH and Frailty Index (FI) criteria. Adverse outcomes measured at 6-month follow-up included falls, hospitalizations, and hospice enrollment/mortality. Results: Based on screening tool used frailty prevalence was 48.7 for FRAIL-NH and 30.3 for FI. The FRAIL-NH pre-frail (Adjusted Odds Ratio AOR= 2.62; 95 Confidence Interval CI= 1.25-5.54; p= 0.11) classification was associated with 6 month risk of falling and mortality/hospice enrollment was associated with the frail classification, AOR= 3.96 (1.44-10.87, p= 0.007). Combining the pre-frail and frail categories both measures predicted 6 month mortality with the FRAIL-NH being the strongest predictor (AOR= 3.36; 95 CI= 1.26-8.98; p= 0.016) and the FI was a more modest predictor with an AOR of 2.28; 95 CI= 1.01-5.15; p= 0.047. When directly comparing the FRAIL-NH to the FI, the FRAIL-NH pre-frail were at increased risk of falling, AOR= 2.42 (1.11-5.92, p= 0.027) and the FRAIL-NH frail were at increased risk of hospice enrollment/death, OR= 3.25 (1.04-10.86) p= 0.044. Conclusion: In comparison to the FI, the FRAIL-NH preformed just as well at screening for frailty and was a slightly better predictor of adverse outcomes. The FRAIL-NH is a brief, easy-to-administer frailty screening tool appropriate for long term care patients and predicts increased risk of falls in the pre-frail and mortality/hospice enrollment in the frail.
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