Conceptualisation of Self-administered Multidimensional Frailty Screening Tools

Frailty is contemporarily understood as a multidimensional construct which consists of physical frailty, cognitive frailty, and social frailty . Preliminary evidence suggested that physical frailty  and cognitive frailty are potentially reversible. Therefore, given the negative impact of being frail and the potential of reversing the frail status, effective screening should be done to identify early at-risk individuals for detailed diagnostics with certified healthcare professions and to develop plans for prevention and treatment. The healthcare system in Singapore is facing an increasing incidence of chronically disabled and elderly patients. To deliver better healthcare value, care integration, strengthening of primary healthcare, and collaboration for health in the community are the three key areas. Hence, an efficient way of identifying frailty and related factors is therefore important because it calls to attention those who require customised healthcare assistance.

Using Singapore as a case example, this study aims to develop a Mobile-based Frailty Screening Tool to help detect frailty early so that it can further reduce the existing healthcare burden. The concept and procedure of self-screening for frailty conditions is still developing on the global stage. The detection for frailty is usually done in primary care setting (e.g., hospitals, clinics) through trained medical personnel and focuses mainly on physical frailty. The current project proposes to develop a multidimensional frailty (physical, cognitive, and social) screening tool that can be self-administered through a smartphone or web-browser (i.e., mobile-based) that is suitable for large-scale screening for the local Singaporean multilingual population. Specifically, we aim to (i) systematically review of the existing physical, cognitive, and social frailty indicators and diagnostics tools to identify the potential to be implemented as a self-screening tool for the senior citizens (50 years or above) and (ii) conceptualise an assistive mobile-based (smartphone or web-based) tools to be used for self-screening of frailty among older adults in the community with different modality such as computerised task or voice-bot to accommodate various literacy and language proficiency levels. 

The proposed self-screening frailty tool will radically improve the process of identifying frailty in the community. It will supplementing the existing frailty assessment that often requires trained personnel/clinician to perform. It can also help to early detect and alerts of pre-frail older adults in the community so that it allows follow up for early frailty intervention to reverse or delay the progression to frailty.