Assessing the strengths and weaknesses of the Clinical Frailty Scale through correlation with a frailty index

Aging Clin Exp Res. 2020 Nov;32(11):2225-2232. doi: 10.1007/s40520-019-01450-w. Epub 2020 Jan 2.


Background: Care for the elderly patient is a challenge that geriatricians now share with other medical specialties. Frailty has emerged as a key concept. Due to its simplicity and applicability, the Clinical Frailty Scale (CFS) is gaining increasing acceptance.

Aim: Compare the CFS with the Frail-VIG index (IF-VIG), an index based on the accumulation of deficits and developed on the basis of comprehensive geriatric assessment.

Methods: Cross-sectional and single-center study carried out at the Acute Geriatric Unit of a University Hospital. Patients consecutively recruited on admission over a 6-month period (n = 184). The concurrent validity of the CFS was measured by assessing the concordance between the two measurement methods. The degree of association was determined by applying a linear regression model, calculating the Pearson correlation coefficient (r).

Results: The prevalence of frailty was 91.8%. A mean IF-VIG score of 0.41 (SD ± 0.14) was found. The two most frequently recorded CFS categories were 6 and 7. An effective correlation was established (r = 0.706, p < 0.001). In the cohort with severe dementia, the association fell (r = 0.442). In the whole population, it rose adding Charlson index score (r = 0.747).

Conclusions: The strong correlation of the CFS with a frailty index supports its use. Incorporating comorbidity into the physical function domains of the CFS improved the correlation. However, the CFS was unsuitable in patients with dementia. To infer prognosis, in categories 6 and 7, the situational diagnosis should be extended with more discriminative tools.

Keywords: Clinical Frailty Scale; Elderly; Frailty; Frailty tools; Geriatric assessment.

MeSH terms

  • Aged
  • Cohort Studies
  • Cross-Sectional Studies
  • Frail Elderly
  • Frailty* / diagnosis
  • Geriatric Assessment
  • Humans