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Background <p>Frailty is a significant issue in older adults and is associated with adverse health outcomes. Screening for frailty in dental settings could identify vulnerable older adults who could benefit from comprehensive geriatric assessment. Our aim was to determine the prevalence of frailty among geriatric patients attending a dental outpatient clinic using two validated tools, the Frailty Assessment and Screening Tool (FAST) and the FRAIL scale, and to evaluate their agreement.</p> Methods <p>A cross-sectional study was conducted among 500 consecutive patients aged ≥ 60 years attending the outpatient department of a tertiary care dental hospital in Bhubaneswar, Odisha, India between June 2025 and December 2025. Frailty was assessed using the 14-item FAST (score ≥ 7 = frail, 5–6 = pre-frail, &lt; 5 = robust) and the 5-item FRAIL scale (score 3–5 = frail, 1–2 = pre-frail, 0 = robust). Demographic data were collected. Statistical analysis included descriptive statistics, Cohen’s kappa for agreement, Spearman’s rank correlation, and binary logistic regression. As no clinical gold standard (like Comprehensive Geriatric Assessment) was employed, analyses of the FRAIL scale against FAST are presented as concordance metrics, not diagnostic accuracy. The study was reported in accordance with the STROBE statement.</p> Results <p>The mean age was 70.8 ± 6.7 years; 410 (82%) were male. According to FAST, 248 (49.6%) were frail, 109 (21.8%) pre-frail, and 143 (28.6%) robust. By FRAIL, 175 (35.0%) were frail, 200 (40.0%) pre-frail, and 125 (25.0%) robust. Agreement between the two scales was moderate (κ = 0.521, 95% CI 0.48–0.56, <i>p</i> &lt; 0.001), with 68.0% concordant classification. The most prevalent deficits on the FAST were limitations in general health (60%), mobility issues (55%), fatigue (50%), memory complaints (50%), and pain limiting daily activities (50%). Age was significantly associated with frailty (OR 1.08 per year, 95% CI 1.05–1.11, <i>p</i> &lt; 0.001). Gender was not a significant predictor in this predominantly male sample, though this analysis is underpowered.</p> Conclusion <p>Frailty is highly prevalent among older adults attending a dental outpatient clinic, with nearly half classified as frail by the multidimensional FAST and over one-third by the simpler FRAIL scale. The two scales show moderate agreement, but FAST captures a broader range of geriatric domains. Routine frailty screening in dental settings may facilitate early identification and referral of at-risk older adults, though further validation against a clinical gold standard is needed.</p>

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Opportunistic screening for frailty in geriatric patients attending a dental outpatient clinic: a cross-sectional comparison of the FAST and FRAIL scales in a tertiary care hospital in India

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  • 发表日期：

    2026年5月25日

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  • Satya Ranjan Misra,
  • Neeta Mohanty,
  • Satya Sundar Gajendra Mohapatra,
  • Rupsa Das,
  • Mahesh Kumar Raybahadur

摘要

Background

Frailty is a significant issue in older adults and is associated with adverse health outcomes. Screening for frailty in dental settings could identify vulnerable older adults who could benefit from comprehensive geriatric assessment. Our aim was to determine the prevalence of frailty among geriatric patients attending a dental outpatient clinic using two validated tools, the Frailty Assessment and Screening Tool (FAST) and the FRAIL scale, and to evaluate their agreement.

Methods

A cross-sectional study was conducted among 500 consecutive patients aged ≥ 60 years attending the outpatient department of a tertiary care dental hospital in Bhubaneswar, Odisha, India between June 2025 and December 2025. Frailty was assessed using the 14-item FAST (score ≥ 7 = frail, 5–6 = pre-frail, < 5 = robust) and the 5-item FRAIL scale (score 3–5 = frail, 1–2 = pre-frail, 0 = robust). Demographic data were collected. Statistical analysis included descriptive statistics, Cohen’s kappa for agreement, Spearman’s rank correlation, and binary logistic regression. As no clinical gold standard (like Comprehensive Geriatric Assessment) was employed, analyses of the FRAIL scale against FAST are presented as concordance metrics, not diagnostic accuracy. The study was reported in accordance with the STROBE statement.

Results

The mean age was 70.8 ± 6.7 years; 410 (82%) were male. According to FAST, 248 (49.6%) were frail, 109 (21.8%) pre-frail, and 143 (28.6%) robust. By FRAIL, 175 (35.0%) were frail, 200 (40.0%) pre-frail, and 125 (25.0%) robust. Agreement between the two scales was moderate (κ = 0.521, 95% CI 0.48–0.56, p < 0.001), with 68.0% concordant classification. The most prevalent deficits on the FAST were limitations in general health (60%), mobility issues (55%), fatigue (50%), memory complaints (50%), and pain limiting daily activities (50%). Age was significantly associated with frailty (OR 1.08 per year, 95% CI 1.05–1.11, p < 0.001). Gender was not a significant predictor in this predominantly male sample, though this analysis is underpowered.

Conclusion

Frailty is highly prevalent among older adults attending a dental outpatient clinic, with nearly half classified as frail by the multidimensional FAST and over one-third by the simpler FRAIL scale. The two scales show moderate agreement, but FAST captures a broader range of geriatric domains. Routine frailty screening in dental settings may facilitate early identification and referral of at-risk older adults, though further validation against a clinical gold standard is needed.