The role of frailty in physicians’ decisions for severe disability

Abstract

Introduction: We aimed to evaluate the correlation between disability approved by the medical board and frailty determined by the Edmonton Frail Scale, which is a tool used to assess frailty. Materials and Method: We enrolled patients admitted to the neurology outpatient clinic of the Bursa Yuksek Ihtisas Training and Research Hospital between 1st-31st March 2019 for examination in order to obtain a disability report from the medical board. Results: Cerebrovascular disease and dementia were more prevalent in older age, while epilepsy, cerebral palsy sequela and other neurological diseases were observed at a younger age. A strong correlation was observed between frailty analysis score and Balthazard disability percentage (p <0,001, r = 0,57). Similarly, there was a correlation between the physicians’ severe disability opinion and the Edmonton Frail index score. Scores for cognition, general health status, functional independence, frequency of forgetting to take prescription drugs, or indications of recent weight loss were higher for patients in the severe disability group who also had higher EFS scores. We found that EFS scores >8 correlate significantly with an increased risk of severe disability. Conclusion: We conclude that use of the frailty analysis score in combination with Balthazard disability percentage for patients applying to the medical board could be practical and rational in evaluating the degree of disability and predicting severe disability. Since only patients who applied for medical board evaluation to the neurology clinic were included in our study, our results are relevant for neurology cases and cannot be generalized for all patients who applied for evaluation.