Practicality and Reliability of Self vs Administered Rapid Geriatric Assessment Mobile App

Abstract

Objectives: To develop and cross-validate self-administered Rapid Geriatric Assessment (SA-RGA) app against administered Rapid Geriatric Assessment (A-RGA) to identify seniors with geriatric syndromes such as frailty, sarcopenia, and anorexia of ageing who may benefit from targeted intervention. Design: Prospective observational study. Setting: Primary Care and Community. Participants: A-RGA and SA-RGA app were administered to older adults ≥ 60 years old from December 2020 to April 2021. Measurements: The RGA app screens for frailty (FRAIL), sarcopenia (SARC-F), anorexia of aging (SNAQ) and cognition (Rapid Cognitive Screen) with assisted management pathway. Patient Health Questionnaire 9 is administered for those who score positive for fatigue. The diagnostic performance of SA-RGA was compared against A-RGA as a reference by calculating the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and positive likelihood ratio (+LR). Results: 123 participants with a mean age of 71 ± 5.9 years completed both the SA-RGA and A-RGA. Questions on fatigue, 5 or more illnesses, loss of weight and falls in the past year performed better with high sensitivity, specificity, NPV and +LR than self-functional assessment where SA-RGA participants reported lower prevalence on the FRAIL scale aerobic and resistance components, and higher prevalence on the SARC-F strength and rising from a chair components. Conclusion: The SA-RGA app performed well in certain domains such as assessment for weight loss, falls, number of chronic illness and fatigue. Self-functional assessment can be improved further by removing ambiguity in wordings such as “some” or “a lot” and replacing it with functional difficulty scale. SA-RGA has the potential to be incorporated in the eHEALTH platforms worldwide for early identifications of older adults at risk and to reduce health inequalities, at the same time building community resilience in the era of Covid-19 pandemic.