Validation of the Spanish version of the Short-Form Late-Life Function and Disability Instrument.

OBJECTIVES: To validate the Short-Form Late-Life Function and Disability Instrument (SF-LLFDI), a valid measure of functional limitations and disability in older adults, in Spanish-speaking populations and to analyze its psychometric properties. DESIGN: Validation study. SETTING: Complejo Hospitalario Universitario de Albacete, Spain. PARTICIPANTS: Sample population of 876 participants aged 70 and older from Albacete, Spain. MEASUREMENTS: Forward and back translation of the SF-LLFDI; concurrent validity was determined according to the Barthel Index and the Lawton Scale for disability and according to grip strength, gait speed, the Timed Up and Go Test, and the Short Physical Performance Battery (SPPB) for function. Construct validity, internal consistency, and floor and ceiling effect were determined. The area under the receiver operating characteristic curve (AUC) was calculated to identify function and disability. Intraclass correlation coefficients (ICCs) were used to analyze reliability in a subsample of 50 participants. RESULTS: The SF-LLFDI was significantly correlated with the Barthel Index (correlation coefficient (r)=0.827), the Lawton Scale (r=0.693), gait speed (r=0.661), and the SPPB (r=0.650). Internal consistency (Cronbach α=0.974), interobserver reliability (ICC=0.989; 95% confidence interval (CI)=0.984-0.993), and intraobserver reliability (ICC=0.982, 95% CI=0.967-0.990) were all excellent. The SF-LLFDI demonstrated excellent discriminant validity, as evidenced by an AUC for a Barthel Index less than 65 points of 0.991 (95% CI=0.986-0.996), with a better cutoff of less than 65 points (sensitivity, 94%; specificity, 94%), and for a Lawton Scale score of less than 4 of 0.976 (95% CI% 0.967-0.985), with a better cutoff of less than 72 (sensitivity, 91%; specificity, 91%). No participant had a maximum score; 36 (4.1%) obtained the minimum. CONCLUSION: The Spanish SF-LLDFI is a valid instrument for detecting disability and functional limitation.

[Frailty and dependence in Albacete (FRADEA study): reasoning, design and methodology]. / Fragilidad y dependencia en Albacete (estudio FRADEA): razonamiento, diseño y metodología.

OBJECTIVE: To obtain a cohort of subjects of equal to or greater than 70 years, representative of a Spanish urban population, to estimate the prevalence of frailty and follow it up over time to analyse associated factors. MATERIAL AND METHODS: A prospective, population-based cohort study. From a population of 18,137 elderly persons, a representative sample of 1172 was randomly stratified, of which 993 (84.7%) agreed to take part. The variables collected were; sociodemographic, comorbidity, functional (n=825), cognitive, affective and quality of life. On the patients who agreed, body composition was determined by bioimpedance analysis (n=557), basal metabolic rate by indirect calorimetry (n=450) and a blood sample was obtained for biomarkers (n=859). Frailty was defined by the presence of 3 or more Fried criteria: unintentional weight loss, low energy, exhaustion, slow walking, and low physical activity. The cohort will be followed up over time until the death of the subjects. RESULTS: Mean age 79.4 (SD 6.4) years, with 601 (60.5%) women. A total of 21.3% were institutionalised; 16.9% were frail, 48.5% pre-frail, 21.3% non-frail, and 12.8% did not have the 3 criteria to be able to determine their state, of which 9.5% had moderate-severe incapacity, which would increase the prevalence of frailty to 26.4%. CONCLUSIONS: A FRADEA cohort has been constructed, representative of an urban population in Spain. The prevalence of frailty in the cohort was 16.9%.