Validation of clinical frailty scale in Chinese translation

• Published in: BMC geriatrics Vol. 22; no. 1; pp. 604 - 9
• Main Authors: Chou, Yi-Chun, Tsou, Hsiao-Hui, Chan, Ding-Cheng Derrick, Wen, Chiung-Jung, Lu, Feng-Ping, Lin, Kun-Pei, Wu, Meng-Chen, Chen, Yung-Ming, Chen, Jen-Hau
• Format: Journal Article
• Language: English
• Published: London BioMed Central 20.07.2022; BioMed Central Ltd; BMC
• Subjects: Activities of daily living; Aged; Aging; China; Chinese languages; Clinical frailty scale; Cognition; Comorbidity; Cross-Sectional Studies; Elderly; Evaluation; Frail Elderly; Frailty; Frailty - diagnosis; Frailty - epidemiology; Geriatric Assessment; Geriatrics; Geriatrics/Gerontology; Hand Strength; Humans; Medicine; Medicine & Public Health; Older people; Phenotypes; Population studies; Quantitative psychology; Questionnaires; Rehabilitation; Reproducibility of Results; Translation; Translations; Translations and translating; Validation studies; China; Taiwan; Clinical frailty scale; Frailty; Elderly; Validation studies
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-022-03287-x

Background Identification of frailty is crucial to guide patient care for the elderly. The Clinical Frailty Scale (CFS) is a reliable, synthesis and clinical judgment-based tool. However, a validated Chinese version of CFS (CFS-C) is lacking. The aim of this study is to describe the translation process of CFS into traditional Chinese and to evaluate its reliability and validity in a geriatric study population in Taiwan. Methods This cross-sectional study recruited 221 geriatric outpatients aged 65 years or older at a medical center in Taipei, Taiwan. The Chinese version of CFS was produced following Brislin’s translation model. Weighted kappa for agreement and Kendall’s tau for correlation were used to assess inter-rater reliability (a subgroup of 52 outpatients) between geriatricians and one research assistant, and validity tests (221 outpatients) by comparing CFS-C with Fried frailty phenotype and Frailty Index based on Comprehensive Geriatric Assessment (FI-CGA). Correlation between CFS-C and other geriatric conditions were also assessed. Results The inter-rater reliability revealed moderate agreement (weighted kappa = 0.60) and strong correlation (Kendall’s tau = 0.67). For criterion validity, CFS-C categorisation showed fair agreement (weighted kappa = 0.37) and significant correlation (Kendall’s tau = 0.46) with Fried frailty phenotype, and higher agreement (weighted kappa = 0.51) and correlation (Kendall’s tau = 0.63) with FI-CGA categorisation. CFS-C was significantly correlated with various geriatric assessments, including functional disability, physical performance, hand grip, comorbidity, cognition, depression, and nutrition status. No significant correlation was found between CFS-C and appendicular muscle mass. Conclusions The CFS-C demonstrated acceptable validity and reliability in Chinese older adults in Taiwan. Development of CFS-C enhanced consistency and accuracy of frailty assessment, both in research and clinical practice.