Research Article: Construction and validation of a frailty screening model for older adults with cataract: a cross-sectional study
Abstract:
To develop and internally validate a frailty screening model for older adults with cataract that relies only on information already collected during routine ophthalmology outpatient assessment.
In this cross-sectional study, 516 patients aged ? 60 years were enrolled and randomly divided into training (n?=?361) and internal validation ( n =?155) sets. Frailty was defined by the FRAIL scale, with non-frail and pre-frail categories combined for the primary binary analysis. Univariate screening was followed by multivariable binary logistic regression, with LASSO and a 5,000-resample bootstrap of the full development procedure as stability checks.
The frailty detection rate was 29.07%. Five factors were independently associated with frailty: advanced age, IADL impairment, poor self-rated health, depression, and history of falls. Discrimination was good (training AUC 0.841, 95% CI 0.796–0.887; validation AUC 0.816, 95% CI 0.745–0.888), the optimism-corrected C-statistic was 0.810 (95% CI 0.780–0.841), and calibration was acceptable (validation Brier score 0.1553). Decision curve analysis showed positive net benefit across a broad threshold range. Lowering the operating point from the Youden cutoff (0.463; sensitivity 57.8%, specificity 86.4%) to 0.181 raised validation sensitivity to 86.7% with a negative predictive value of 92.1%.
Because all five predictors are already recorded during routine cataract assessment, the model offers an opportunistic, zero-burden triage step for identifying concurrent frailty and prompting comprehensive geriatric assessment. External validation and comparison with the FRAIL scale are required.
Introduction:
Frailty is a geriatric syndrome characterized by age-related decline in physiological reserves and intrinsic capacity, and is associated with significantly increased vulnerability to stressors and heightened risk of various adverse health outcomes ( 1 – 3 ). Globally, the prevalence of frailty ranges from 12% to 24%, making it a widespread public health concern ( 4 , 5 ). In China, the pooled prevalence of frailty among community-dwelling Chinese older adults aged 60 years and above has been reported at…
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