Comprehensive Geriatric Assessment Domains and Routine Inflammatory Indices in Relation to Clinical Frailty Scale-Defined Frailty: A Cross-Sectional Study in Hospital-Based Older Adults

Abstract

Background/Objectives: Frailty in older adults is multidimensional, but the added value of routine blood-based inflammatory indices beyond comprehensive geriatric assessment is uncertain. In a hospital-based sample we examined how Clinical Frailty Scale (CFS)-defined frailty relates to geriatric domains and to inflammatory/prognostic indices, and whether these indices improve the cross-sectional classification of frailty beyond a core geriatric model. Methods: In this single-center, cross-sectional study, 284 of 300 consecutive records of adults aged 65 years or older who underwent comprehensive geriatric assessment at a family medicine-run healthy aging outpatient clinic in a university hospital were analyzed after data-quality checks. Frailty was defined as a CFS score of 5 or higher. Function, nutrition, cognition, mood, and mobility were assessed with Katz Activities of Daily Living (ADL), Lawton Instrumental Activities of Daily Living (IADL), Mini Nutritional Assessment (MNA), Mini-Cog, Geriatric Depression Scale-15, and Timed Up and Go (TUG). Five inflammatory/prognostic indices, including the platelet-to-lymphocyte ratio (PLR), were recalculated from same-day laboratory values. Logistic regression and receiver operating characteristic analyses compared a basic clinical model, a core geriatric model, and index-added models, with bootstrap assessment of calibration and optimism. Results: Frailty prevalence was 54.6% (95% confidence interval [CI]: 48.8–60.3). The area under the curve was 0.611 in the basic clinical model and 0.866 (95% CI: 0.821–0.907) in the core geriatric model (optimism-corrected 0.842; calibration slope 0.81). Because several geriatric measures overlap conceptually with CFS grading, reduced models were fitted: omitting Katz ADL, Lawton IADL, and Mini-Cog gave an area under the curve of 0.779 (95% CI: 0.721–0.833), while additionally omitting MNA and TUG gave 0.657 (95% CI: 0.592–0.719), close to the basic clinical model. Inflammatory indices provided no consistent incremental contribution; the small increase with PLR had a bootstrap confidence interval that included zero. Conclusions: In this sample, comprehensive geriatric assessment domains demonstrated a stronger association with same-time CFS-defined frailty classification than routine blood-based inflammatory indices. The findings describe contemporaneous classification in very old, hospital-based patients and do not establish prospective predictive value.