Multidimensional frailty in older people in general practitioners’ clinical practice: the SELFY-MPI SIGOT project

Abstract

The multidimensional prognostic index (MPI) is a comprehensive geriatric assessment (CGA) tool exploring the multiple domains of older subject. The knowledge and the diffusion of self-assessment tools for identifying frailty in general medicine is still limited. The aim of our study is to determine the prevalence of frailty using a multidimensional frailty screening tool (SELFY-MPI) in a cohort of older adults, belonging to the general practitioner’s (GPs) experience. In the frame of a national educational program organized by the Italian Geriatric Hospital and Community Society (SIGOT), expert geriatricians carried-out local courses addressed to GPs, focused on multidimensional approach in primary care. A cross-sectional study of the SELFY-MPI, based on eight different domains, in the general practitioners’ outpatient clinic was performed among 50 GPs. SELFY-MPI risk score was used for dividing the participants in robust, pre-frail, or frail. A total of 526 participants (mean age: 77.7 years; females=55.3%) fulfilled the SELFY-MPI. The participants were, on average, independent in the activities of daily living, had a good mobility, but they reported some cognitive difficulties, and they can be considered at risk of malnutrition. A high prevalence of comorbidities and polypharmacotherapy was also present. The 20.2% of the sample lived alone, suggesting a potential social frailty. The mean SELFY-MPI score was 0.26 0.17: therefore, 21.67% of the participants were categorized as pre-frail, and 3.99% as frail. Pre-frailty and frailty are common in GPs experience. SELFY-MPI is a feasible screening tool for multidimensional frailty in the GPs clinical practice.

Keywords

• Multidimensional prognostic index
• primary care
• frailty.