Agreement of a Short Form of the Self-Administered Multidimensional Prognostic Index (SELFY-MPI-SF): A Useful Tool for the Self-Assessment of Frailty in Community-Dwelling Older People
Received 11 December 2019
Accepted for publication 17 February 2020
Published 30 March 2020 Volume 2020:15 Pages 493—499
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Richard Walker
Alberto Cella,1 Alberto Ferrari,2 Giuseppe Rengo,3 Vincenzo Solfrizzi,4 Nicola Veronese,5 Matteo Puntoni,6 Sabrina Zora,1 Alberto Pilotto,1,4 Filippo Fimognari7 On behalf of the SELFY-MPI SIGOT Investigators
1Geriatric Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, EO Galliera Hospital, Genova, Italy; 2Geriatric Unit, Arcispedale S. Maria Nuova, AUSL Reggio Emilia, Reggio Emilia, Italy; 3Department of Translational Medical Sciences, Division of Geriatrics, Federico II University, Napoli, Italy; 4Department of Interdisciplinary Medicine, University of Bari, Bari, Italy; 5Primary Care Department, Azienda ULSS 3 Serenissima, Venice, Italy; 6Scientific Coordination Unit, EO Galliera Hospital, Genova, Italy; 7Geriatric Unit, Department of Internal Medicine, Azienda Ospedaliera di Cosenza, Cosenza, Italy
Correspondence: Sabrina Zora
Geriatric Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, EO Galliera Hospital, Genova, Italy
Background: The Multidimensional Prognostic Index (MPI) is a comprehensive geriatric assessment (CGA)-based tool that has shown excellent accuracy in predicting negative health outcomes in older people. Recently, the self-administered version of MPI (SELFY-MPI) has been validated in a community-dwelling sample, revealing excellent agreement with the original MPI. In the SELFY-MPI, Gijon’s social-familial evaluation scale (SFES) was used to assess socio-relational and economic aspects. Completion of the SELFY-MPI, however, requires a significant amount of time in people aged over 60 years, particularly to fill in the SFES scale. The aim of this study was to validate, in a sample of community-dwelling older people, a short-form version of the SELFY-MPI (SELFY-MPI-SF), in which the SFES scale was replaced by the “co-habitation status” domain, as in the original version of the MPI.
Methods: All participants included in the study completed both versions of the self-administered MPI, which share the following seven domains: 1) basic and 2) instrumental activities of daily living, 3) mobility, 4) cognition, 5) nutrition, 6) comorbidity, and 7) number of medications. Moreover, in the SELFY-MPI-SF, the 8th domain “co-habitation status” (ie living alone, with family or in a residential facility) replaced the SFES scale. The Bland–Altman methodology was applied in order to measure the agreement between the two instruments. Finally, the time to complete the SFES scale and the question on co-habitation was measured.
Results: The final study sample was composed of 129 participants (mean age=76.8 years, range=65– 93 years, 64.3% women) were enrolled. The mean SELFY-MPI and SELFY-MPI-SF values were 0.221± 0.196 and 0.246± 0.188, respectively. The mean difference was clinically irrelevant (− 0.025± 0.058). None of the 129 observations showed values outside the established 5% limits of agreement. The agreement between SELFY-MPI and SELFY-MPI-SF was excellent (k=0.762; rho=0.924, p< 0.0001 for both). Stratified analyses of agreement among subgroups of participants of different ages did not show any significant differences between the two versions. Completion of the SFES required about 7 mins, on average, while the question on habitation status required about 10 s.
Conclusion: The SELFY-MPI-SF showed strong agreement and precision when compared with the standard SELFY-MPI in people aged 65 and older and can therefore be successfully used as a quicker self-administered frailty instrument in community-dwelling older people.
Keywords: comprehensive geriatric assessment, multidimensional prognostic index, frailty, self assessment
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