Frailty Screening (FRAIL-NH) and Mortality in French Nursing Homes : Results From the Incidence of Pneumonia and Related Consequences in Nursing Home Residents Study

OBJECTIVES: To investigate the ability of the fatigue, resistance, ambulation, incontinence or illness, loss of weight, nutritional approach, and help with dressing (FRAIL-NH) tool to predict mortality. DESIGN: The Incidence of Pneumonia and Related Consequences in Nursing Home Residents (INCUR) study database was used. This was an observational cohort study in French nursing homes conducted over 12 months in 2012. PARTICIPANTS: A total of 788 residents aged 60 years or older, from 13 randomly selected French nursing homes. MEASUREMENTS: FRAIL-NH was generated from the available variables at baseline. FRAIL-NH scores ranged from 0 to 14 and people were categorized as nonfrail (0‒1), frail (2‒5), and most frail (6‒14). Mortality data were obtained from medical charts and confirmed by the nursing home administrative documentation. RESULTS: Mean age of the participants was 86.2 ± 7.5 years, and 74.5% were women. The prevalence of persons with FRAIL-NH score greater than 1 was 88.8%, with 54.2% and 34.6% of residents identified as most frail and frail, respectively. The mean FRAIL-NH score was 6.0 ± 3.4. Women (N = 583) were frailer (6.1 ± 3.4) than men (N = 200, 5.5 ± 3.4; P = .027). Overall, 136 residents died over the 1-year follow-up period. The FRAIL-NH score was a predictor of mortality (adjusted hazard ratios: for frail group 1.15, 95% confidence interval 0.55‒2.41; for most frail group 2.14, 95% confidence interval 1.07‒ 4.27). CONCLUSIONS: FRAIL-NH is a predictor of mortality in nursing home residents and the score could assist with guiding appropriate care planning.