Determining Frailty in People With Intellectual Disabilities During the COVID-19 Pandemic
Journal of Applied Research in Intellectual Disabilities
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Background: During the COVID-19 pandemic, the Clinical Frailty Scale (CFS) is used in guidelines for triaging in crisis situations. The CFS identifies frail individuals mainly based on performance of daily tasks. Individuals with intellectual disabilities experience lifelong dependence to varying degrees. Using the CFS for triage could potentially unjustifiably classify them as too frail and exclude them from Intensive Care treatment. We compared the classification of individuals with intellectual disabilities into different frailty categories based on the CFS and the well-investigated ID-Frailty Index, to determine suitability for evaluation during the COVID-19 pandemic. Method: Participants with intellectual disabilities (n=982, ≥50 years) from the HA-ID study were classified into frailty categories according to the CFS and the ID-Frailty Index. Results: Based on the CFS, 63.7% would be classified as moderately frail, while 92% were not moderately frail according to the ID-Frailty Index. Additionally, 20.3% would be classified as at least severely frail with CFS, while 74.9% were not severely frail according to the ID-Frailty Index. Overall, 730/982 (74.9%) would be incorrectly classified as too frail by the CFS. Conclusions: The CFS is not suitable to evaluate frailty in individuals with intellectual disabilities, with potential dramatic consequences for triage and decision-making during the COVID-19 pandemic.
Disability Studies | Virus Diseases
Determining Frailty in People With Intellectual Disabilities During the COVID-19 Pandemic.
Journal of Applied Research in Intellectual Disabilities, 34(5),