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


Submitted: 29 January 2022
Accepted: 10 February 2022
Published: 18 March 2022
Abstract Views: 2071
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Authors

  • Alberto Pilotto Department Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genova; Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy.
  • Stefania Maggi National Research Council (CNR), Neuroscience Department, Aging Branch, Padova, Italy.
  • Alberto Ferrari 3C Salute - Impresa Sociale scs, Reggio Emilia, Italy.
  • Giuseppe Rengo Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Napoli, Napoli, Italy.
  • Vincenzo Solfrizzi Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy.
  • Sabrina Zora Department Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genova, Italy.
  • Ovidio Brignoli General Practitioner Department of Primary Care, ATS Brescia, Italy.
  • Pierangelo Lora Aprile General Practitioner Department of Primary Care, ATS Brescia, Italy.
  • Giuseppe Fascella Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.
  • Ligia J. Dominguez Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.
  • Nicola Veronese Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.
  • Alberto Cella Department Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genova, Italy.
  • on behalf of the SELFY-MPI SIGOT Project

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.


Siontis GC, Tzoulaki I, Ioannidis JP. Predicting death: an empirical evaluation of predictive tools for mortality. Archiv Intern Med 2011;171:1721-6. DOI: https://doi.org/10.1001/archinternmed.2011.334

Gill TM. The central role of prognosis in clinical decision making. JAMA 2012;307:199-200. DOI: https://doi.org/10.1001/jama.2011.1992

Pilotto A, Cella A, Pilotto A, et al. Three decades of comprehensive geriatric assessment: evidence coming from different healthcare settings and specific clinical conditions. J Am Med Direct Assoc 2017;18:192.e1-e11. DOI: https://doi.org/10.1016/j.jamda.2016.11.004

Pilotto A, Ferrucci L, Franceschi M, et al. Development and validation of a multidimensional prognostic index for one-year mortality from comprehensive geriatric assessment in hospitalized older patients. Rejuven Res 2008;11:151-61. DOI: https://doi.org/10.1089/rej.2007.0569

Pilotto A, Custodero C, Maggi S, et al. A multidimensional approach to frailty in older people. Ageing Res Rev 2020;60:101047. DOI: https://doi.org/10.1016/j.arr.2020.101047

Zora S, Custodero C, Pers Y-M, et al. Impact of the chronic disease self-management program (CDSMP) on self-perceived frailty condition: the EU-EFFICHRONIC project. Ther Adv Chronic Dis 2021;12:20406223211056722. DOI: https://doi.org/10.1177/20406223211056722

Avila-Funes J, Gutierrez-Robledo L, de Leon-Rosales SP. Validity of height and weight self-report in Mexican adults: results from the national health and aging study. J Nutr Health Aging 2004;8:355-61.

Nunes DP, Duarte YAdO, Santos JLF, Lebrão ML. Screening for frailty in older adults using a self-reported instrument. Rev Saude Publ 2015;49. DOI: https://doi.org/10.1590/S0034-8910.2015049005516

Pialoux T, Goyard J, Lesourd B. Screening tools for frailty in primary health care: a systematic review. Geriatr Gerontol Internat 2012;12:189-97. DOI: https://doi.org/10.1111/j.1447-0594.2011.00797.x

Zora S, Guerrero KLQ, Veronese N, et al. Implementation of the SELFY-MPI in five European Countries: a multicenter international feasibility study. Geriatric Care 2019;5(3). DOI: https://doi.org/10.4081/gc.2019.8502

Cella A, Ferrari A, Rengo G, et al. 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. Clin Interv Aging 2020;15:493. DOI: https://doi.org/10.2147/CIA.S241721

Pilotto A, Veronese N, Quispe Guerrero KL, et al. Development and validation of a self-administered multidimensional prognostic index to predict negative health outcomes in community-dwelling persons. Rejuven Res 2019;22:299-305. DOI: https://doi.org/10.1089/rej.2018.2103

Mahoney FI. Functional evaluation: the Barthel index. Maryland State Med J 1965;14:61-5. DOI: https://doi.org/10.1037/t02366-000

Patricia P. Katz for the Association of Rheumatology Health Professionals Outcomes Measures Task Force: Measures of adult general functional status: The Barthel Index, Katz Index of Activities of Daily Living, Health Assessment Questionnaire (HAQ), MACTAR Patient Preference Disability Questionnaire, and Modified Health Assessment Questionnaire (MHAQ). Arthrit Care Res 2003;49:S15-27. DOI: https://doi.org/10.1002/art.11415

Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9:179-86. DOI: https://doi.org/10.1093/geront/9.3_Part_1.179

Goeppinger J, Doyle M, Murdock B, et al. Self-administered function measures: the impossible dream. Arthritis Rheum 1985;28:145.

Brown J, Pengas G, Dawson K, et al. Self administered cognitive screening test (TYM) for detection of Alzheimer’s disease: cross sectional study. BMJ 2009;338. DOI: https://doi.org/10.1136/bmj.b2030

Kaiser MJ, Bauer JM, Ramsch C, et al. Validation of the Mini Nutritional Assessment Short-Form (MNA®-SF): A practical tool for identification of nutritional status. JNHA J Nutr Health Aging 2009;13:782-8. DOI: https://doi.org/10.1007/s12603-009-0214-7

Donini LM, Marrocco W, Marocco C, Lenzi A. Validity of the self-mini nutritional assessment (Self-MNA) for the evaluation of nutritional risk. A cross-sectional study conducted in general practice. JNHA J Nutr Health Aging 2018;22:44-52. DOI: https://doi.org/10.1007/s12603-017-0919-y

Linn BS, Linn MW, Gurel L. Cumulative illness rating scale. J Am Geriatr Soc 1968;16:622-6. DOI: https://doi.org/10.1111/j.1532-5415.1968.tb02103.x

Veronese N, Custodero C, Cella A, et al. Prevalence of multidimensional frailty and pre-frailty in older people in different settings: a systematic review and meta-analysis. Ageing Res Rev 2021:101498. DOI: https://doi.org/10.1016/j.arr.2021.101498

Canevelli M, Cesari M, van Kan GA. Frailty and cognitive decline: how do they relate? Curr Opin Clin Nutr Metab Care 2015;18:43-50. DOI: https://doi.org/10.1097/MCO.0000000000000133

Comijs HC, Dik MG, Aartsen MJ, et al. The impact of change in cognitive functioning and cognitive decline on disability, well-being, and the use of healthcare services in older persons. Dementia Geriatr Cognit Disord 2005;19:316-23. DOI: https://doi.org/10.1159/000084557

Laur CV, McNicholl T, Valaitis R, Keller HH. Malnutrition or frailty? Overlap and evidence gaps in the diagnosis and treatment of frailty and malnutrition. Appl Physiol Nutr Metab 2017;42:449-58. DOI: https://doi.org/10.1139/apnm-2016-0652

Volpato S, Custureri R, Puntoni M, et al. Effects of oral amino acid supplementation on Multidimensional Prognostic Index in hospitalized older patients: a multicenter randomized, double-blind, placebo-controlled pilot study. Clin Intervent Aging 2018;13:633. DOI: https://doi.org/10.2147/CIA.S154998

Veronese N, Stubbs B, Noale M, et al. Polypharmacy is associated with higher frailty risk in older people: an 8-year longitudinal cohort study. J Am Med Direct Assoc 2017;18:624-8. DOI: https://doi.org/10.1016/j.jamda.2017.02.009

Pilotto, A., Maggi, S., Ferrari, A., Rengo, G., Solfrizzi, V., Zora, S., Brignoli, O., Lora Aprile, P., Fascella, G., Dominguez, L. J., Veronese, N., Cella, A., & the SELFY-MPI SIGOT Project, on behalf of . (2022). Multidimensional frailty in older people in general practitioners’ clinical practice: the SELFY-MPI SIGOT project. Geriatric Care, 8(1). https://doi.org/10.4081/gc.2022.10388

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