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Background: Frailty is a dynamic condition that is clinically expected to change in older individuals during and around admission to an intermediate care (IC) facility. We aimed to characterize transitions between degrees of frailty before, during, and after admission to IC and assess the impact of these transitions on health outcomes., Methods: Multicentre observational prospective study in IC facilities in Catalonia (North-east Spain). The analysis included all individuals aged ≥ 75 years (or younger with chronic complex or advanced diseases) admitted to an IC facility. The primary outcome was frailty, measured by the Frail-VIG index and categorized into four degrees: no frailty, and mild, moderate, and advanced frailty. The Frail-VIG index was measured at baseline (i.e., 30 days before IC admission) (Frail-VIG 0 ), on IC admission (Frail-VIG 1 ), at discharge (Frail-VIG 2 ), and 30 days post-discharge (Frail-VIG 3 )., Results: The study included 483 patients with a mean (SD) age of 81.3 (10.2) years. At the time of admission, 27 (5.6%) had no frailty, and 116 (24%), 161 (33.3%), and 179 (37.1%) mild, moderate, and severe frailty, respectively. Most frailty transitions occurred within the 30 days following admission to IC, particularly among patients with moderate frailty on admission. Most patients maintained their frailty status after discharge. Overall, 135 (28%) patients died during IC stay. Frailty, measured either at baseline or admission, was significantly associated with mortality, although it showed a stronger contribution when measured on admission (HR 1.16; 95%CI 1.10-1.22; p < 0.001) compared to baseline (HR 1.10; 1.05-1.15; p < 0.001). When including frailty measurements at the two time points (i.e., baseline and IC admission) in a multivariate model, frailty measured on IC admission but not at baseline significantly contributed to explaining mortality during IC stay., Conclusions: Frailty status varied before and during admission to IC. Of the serial frailty measures we collected, frailty on IC admission was the strongest predictor of mortality. Results from this observational study suggest that routine frailty measurement on IC admission could aid clinical management decisions., (© 2022. The Author(s).)

Background: Demographic changes have led to an increase in the number of elderly frail persons and, consequently, systematic geriatric assessment is more important than ever. Frailty Indexes (FI) may be particularly useful to discriminate between various degrees of frailty but are not routinely assessed due, at least in part, to the large number of deficits assessed (from 30 to 70). Therefore, we have developed a new, more concise FI for rapid geriatric assessment (RGA)-the Frail-VIG index ("VIG" is the Spanish/Catalan abbreviation for Comprehensive Geriatric Assessment), which contains 22 simple questions that assess 25 different deficits. Here we describe this FI and report its ability to predict mortality at 24 months., Methods: Prospective, observational, longitudinal study of geriatric patients followed for 24 months or until death. The study participants were patients (n = 590) admitted to the Acute Geriatric Unit at the at the University Hospital of Vic (Barcelona) during the year 2014. Participants were classified into one of seven groups based on their Frail-VIG score (0-0.15; 0.16-0.25; 0.26-0.35; 0.36-0.45; 0.46-0.55; 0.56-0.65; and 0.66-1). Survival curves for these groups were compared using the log-rank test. ROC curves were used to assess the index's capacity to predict mortality at 24 months., Results: Mean (standard deviation) patient age was 86.4 (5.6) years. The 24-month mortality rate was 57.3% for the whole sample. Significant between-group (deceased vs. living) differences (p < 0.05) were observed for most index variables. Survival curves for the seven Frail-VIG groups differed significantly (X 2  = 433.4, p < 0.001), with an area under the ROC curve (confidence interval) of 0.90 (0.88-0.92) at 12 months and 0.85 (0.82-0.88) at 24 months. Administration time for the Frail-VIG index ranged from 5 to 10 min., Conclusions: The Frail-VIG index, which requires less time to administer than previously validated FIs, presents a good discriminative capacity for the degree of frailty and a high predictive capacity for mortality in the present cohort. Although more research is needed to confirm the validity of this instrument in other populations and settings, the Frail-VIG may provide clinicians with a RGA method and also a reliable tool to assess frailty in routine practice.