Deliverable 2.1 – Shared vision – April 2014

This deliverable sets out the rationale and methods for developing PERSSILAAs’ shared vision regarding the screening of frailty and triage of patients through PERSSILAAs’ screening protocol. Through a state of the art literature review, different definitions of frailty are discussed in order to develop a consensus or “common vision” for the project. Based upon this exploration the consortium agreed to adopt the European Innovation Partnership on Active and Healthy Aging definition. Also, the advantages and disadvantages of the myriad of frailty screening instruments available are reviewed, again setting out the rationale for selecting suitable tools to assess and triage the population that will be targeted by PERSSILAAs’ service model, namely pre-frail, community dwelling older adults age over 65 years. The rationale for selecting the three key or “core domains” that will be targeted in this project are explained, namely nutrition, cognition and physical function. By establishing suitable screening instruments for these, it also helps clarify the screening and triage pathway for the subsequent validation arm of the project.

PERSSILAA will target pre-frail community dwelling older adults (>65 years) with a two-step screening protocol. Initial screening will involve a postal/online questionnaire requesting demographic data. Frailty will be assessed with the Groningen Frailty Indicator (a 15-point yes-no questionnaire exploring physical, cognitive, social and psychological components of frailty) with additional information gathered from the INTERMED screen (chronic disease) and three objective home administered tests, the Quick Memory Check (cognitive), the Mini-Nutritional Assessment sections A-F (nutrition) and the KATZ activities of daily living scale and the RAND-36 (physical function). Thus, step one screening will exclude clearly robust or frail patients. Step two will involve more detailed assessment and stratification of patients at risk of progressing to frailty. Pre-frailty will be confirmed using the Fried frailty criteria and patients will be grouped into eight subgroups according to their baseline cognitive (using the Quick Mild Cognitive Impairment screen and observer rated AD8), nutritional (using the Mini-Nutritional Assessment sections G-R), and physical (specific functional tests including the timed up-and-go test) status for evaluation in the validation arm of the PERSSILAA project.

The full document: D2.1