2025, Volume 18, Issue 9, pp 854 – 862

Predictive performance of the Zulfiqar Frailty Scale for 12-month morbidity and mortality in community-dwelling older adults attending general practice

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Authors and Affiliations

* Corresponding author Abrar-Ahmad Zulfiqar, Internal Medicine Department, Strasbourg University Hospitals, Strasbourg, France; E-mail: abzulfiqar@gmail.com

Abstract

Frailty in older adults is a syndrome associated with increased morbidity and mortality. The Zulfiqar Frailty Scale (ZFS) was developed to facilitate the assessment of frailty in general practice. This study aimed to assess the predictive capacity of the ZFS over 12 months for events such as falls, hospitalizations, changes in treatment, and mortality. A prospective study was conducted in a general practice over a 12-month period. Patients aged 65 and over were included and assessed using the ZFS at T0 months, followed by assessment at T12 months. Data collected included demographic information, medical history, hemoglobin level over the last 3 months, and hemoglobin level at 12 months, as well as the occurrence of adverse events (falls, fractures, hospitalizations, and death). Statistical analyses were performed using ROC curves to determine the performance of the ZFS scale. Of the 135 patients included, 24% were considered frail at T0, and this figure rose to 28% at T12 months. The ZFS showed good predictive capacity for the occurrence of falls (AUC = 0.75) and hospitalizations (AUC = 0.64). Frail patients, according to the ZFS, had a significantly higher risk of falling (P < 0.05) and were hospitalized more frequently (P < 0.001) than non-frail patients. Concerning mortality, although the number of deaths was low (3 deaths), the ZFS showed an AUC of 0.87, indicating a good predictive capacity. On the other hand, the prediction of fractures (AUC = 0.62) and new comorbidities (AUC = 0.51) performed less well. The ZFS is a promising tool for screening for frailty and predicting certain clinical events such as falls and hospitalizations. However, for more comprehensive predictions (fractures, comorbidities), association with other assessment tools is recommended.

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About this article

PMC ID: PMC12577788
PubMed ID: 41178900
DOI: 10.25122/jml-2025-0094

Article Publishing Date (print):
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Journal information

ISSN Printing: 1844-122X
ISSN Online: 1844-3117
Journal Title: Journal of Medicine and Life

Copyright License: Open Access

This article is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use and redistribution provided that the original author and source are credited.

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