ArticleBMC geriatrics2026
Development and validation of the Frailty Questionnaire-5 (FQ-5), a PRISMA-7-derived screening tool for frailty: a diagnostic accuracy study in primary care.
Article in BMC geriatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFrailty is a common geriatric syndrome associated with falls, disability, hospitalization, and mortality. Primary care screening tools must be simple, time-efficient, and accurate. This study aimed to develop and validate the Frailty Questionnaire-5 (FQ-5), adapted from the PRISMA-7, for frailty screening in a primary care setting.
methodsWe conducted a cross-sectional study of 328 ambulatory, community-dwelling older adults (age 60-91 years; 84 males, 244 females) recruited via consecutive sampling in suburban Northeast Thailand. Following linguistic validation of PRISMA-7, the FQ-5 was developed by removing two low-performing items and adjusting the age threshold. Criterion validity and clinical association were assessed against the modified Thai Frailty Index (mTFI). Internal consistency and 7-14-day test-retest reliability (n = 33) were also evaluated.
resultsFrailty prevalence was 29.9% (n = 98) according to the mTFI and 24.1% (n = 79) based on the Thai PRISMA-7 (cutoff ≥ 3). For the FQ-5, prevalence varied by threshold: 53.7% (n = 176) at cutoff ≥ 1 and 24.7% (n = 81) at cutoff ≥ 2. The FQ-5 demonstrated good discrimination (AUC = 0.81; 95% CI: 0.76-0.86). A cutoff ≥ 2 achieved the highest overall classification accuracy (80.8%), with sensitivity 59.2% and specificity 90.0% (dOR = 13.05). Meanwhile, a cutoff ≥ 1 maximized sensitivity (84.7%) at the expense of specificity (59.6%). The FQ-5 was significantly associated with adverse outcomes, including ADL dependency and falls. Test-retest reliability was excellent (ICC = 0.86) and precision (SEM = 0.42, MDC = 1.17), with no significant systematic bias (mean difference = -0.12).
conclusionThe FQ-5 is a brief, reliable, and clinically relevant frailty screening tool for Thai primary care, with potential for adaptation in countries with similar healthcare and demographic profiles. In practice, FQ-5 ≥ 2 is suitable for rule-in screening in primary care, whereas ≥ 1 supports early case-finding to prompt full frailty assessment.
trial registrationThai Clinical Trials Registry (TCTR), TCTR20250818010; registered 18 August 2025 (retrospectively registered).
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