Screening for markers of frailty and perceived risk of adverse outcomes using the Risk Instrument for Screening in the Community (RISC)

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dc.contributor.author O'Caoimh, Rónán
dc.contributor.author Gao, Yang
dc.contributor.author Svendrovski, Anton
dc.contributor.author Healy, Elizabeth
dc.contributor.author O'Connell, Elizabeth
dc.contributor.author O'Keeffe, Gabrielle
dc.contributor.author Cronin, Una
dc.contributor.author O'Herlihy, Eileen
dc.contributor.author Cornally, Nicola
dc.contributor.author Molloy, D. William
dc.date.accessioned 2016-01-21T09:33:48Z
dc.date.available 2016-01-21T09:33:48Z
dc.date.issued 2014-09-19
dc.identifier.citation O’CAOIMH, R., GAO, Y., SVENDROVSKI, A., HEALY, E., O’CONNELL, E., O’KEEFFE, G., CRONIN, U., O’HERLIHY, E., CORNALLY, N. & MOLLOY, W. D. 2014. Screening for markers of frailty and perceived risk of adverse outcomes using the Risk Instrument for Screening in the Community (RISC). BMC Geriatrics, 14:401, 1-12. http://dx.doi.org/10.1186/1471-2318-14-104 en
dc.identifier.volume 14 en
dc.identifier.startpage 1 en
dc.identifier.endpage 12 en
dc.identifier.issn 1471-2318
dc.identifier.uri http://hdl.handle.net/10468/2207
dc.identifier.doi 10.1186/1471-2318-14-104
dc.description.abstract BACKGROUND: Functional decline and frailty are common in community dwelling older adults, increasing the risk of adverse outcomes. Given this, we investigated the prevalence of frailty-associated risk factors and their distribution according to the severity of perceived risk in a cohort of community dwelling older adults, using the Risk Instrument for Screening in the Community (RISC). METHODS: A cohort of 803 community dwelling older adults were scored for frailty by their public health nurse (PHN) using the Clinical Frailty Scale (CFS) and for risk of three adverse outcomes: i) institutionalisation, ii) hospitalisation and iii) death, within the next year, from one (lowest) to five (highest) using the RISC. Prior to scoring, PHNs stated whether they regarded patients as frail. RESULTS: The median age of patients was 80 years (interquartile range 10), of whom 64% were female and 47.4% were living alone. The median Abbreviated Mental Test Score (AMTS) was 10 (0) and Barthel Index was 18/20 (6). PHNs regarded 42% of patients as frail, while the CFS categorized 54% (scoring ≥5) as frail. Dividing patients into low-risk (score one or two), medium-risk (score three) and high-risk (score four or five) using the RISC showed that 4.3% were considered high risk of institutionalization, 14.5% for hospitalization, and 2.7% for death, within one year of the assessment. There were significant differences in median CFS (4/9 versus 6/9 versus 6/9, p < 0.001), Barthel Index (18/20 versus 11/20 versus 14/20, p < 0.001) and mean AMTS scores (9.51 versus 7.57 versus 7.00, p < 0.001) between those considered low, medium and high risk of institutionalisation respectively. Differences were also statistically significant for hospitalisation and death. Age, gender and living alone were inconsistently associated with perceived risk. Frailty most closely correlated with functional impairment, r = −0.80, p < 0.001. CONCLUSION: The majority of patients in this community sample were perceived to be low risk for adverse outcomes. Frailty, cognitive impairment and functional status were markers of perceived risk. Age, gender and social isolation were not and may not be useful indicators when triaging community dwellers. The RISC now requires validation against adverse outcomes. en
dc.description.sponsorship Health Service Executive, Ireland (South) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Biomed Central Ltd. en
dc.rights © 2014 O’Caoimh et al.; licensee BioMed Central Ltd., 2014. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. en
dc.rights.uri http://creativecommons.org/licenses/by/4.0/ en
dc.subject Screening en
dc.subject Frailty en
dc.subject Risk en
dc.subject Adverse outcomes en
dc.subject Clinical frailty scale (CFS) en
dc.subject Risk instrument for screening in the community (RISC) en
dc.subject Public health nurses (PHNs) en
dc.subject Comorbidities en
dc.subject Cognitive impairment en
dc.subject Barthel index (BI) en
dc.subject Abbreviated mental test score (AMTS) en
dc.subject Mild cognitive impairment en
dc.subject Vulnerable elders survey en
dc.subject Older people en
dc.subject Mortality en
dc.subject Identification en
dc.subject Care en
dc.title Screening for markers of frailty and perceived risk of adverse outcomes using the Risk Instrument for Screening in the Community (RISC) en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother William D. Molloy, Centre for Gerontology and Rehabilitation, School of Medicine, UCC , University College Cork, Cork, Ireland. +353-21-492-3165 Email: w.molloy@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Health Service Executive, Ireland en
dc.description.status Peer reviewed en
dc.identifier.journaltitle BMC Geriatrics en
dc.internal.copyrightchecked Open Access articles licensed via CC-BY 4.0 with UCC affiliated authors. Uploaded Jan 2016. en
dc.internal.IRISemailaddress w.molloy@ucc.ie en
dc.identifier.articleid 401


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© 2014 O’Caoimh et al.; licensee BioMed Central Ltd., 2014. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Except where otherwise noted, this item's license is described as © 2014 O’Caoimh et al.; licensee BioMed Central Ltd., 2014. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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