Frail Elderly Syndrome (00257) in Community-Dwelling Older Adults: Clinical Validity and Implications

Abstract

Purpose

To determine the diagnostic accuracy of the defining characteristics for the Frail elderly syndrome (00257) diagnosis (NANDA-I 2021-2023 edition) in community-dwelling older adults.

Methods

A cross-sectional study was conducted between February and May 2022, involving a sample of 148 older adults. Clinical validation was performed using latent class analysis, which was used to calculate accuracy, sensitivity, and specificity measures with their respective 95% confidence intervals for the defining characteristics. The likelihood ratio test (G2) was applied to assess the goodness of fit of the obtained models (p > 0.05). The study was approved by the Ethics Committee.

Findings

A total of 17 defining characteristics were validated. Two latent class models were proposed, with Model 2 demonstrating superior fit and higher entropy. The nursing diagnosis achieved a prevalence of 50.7% in the sample. The most accurate defining characteristics were impaired physical mobility (00085) and impaired walking ability (00088), both with sensitivity and specificity values exceeding 85.9. Additional characteristics not originally included in the diagnosis were also identified and validated: insomnia (00095), impaired dentition (00048), urge urinary incontinence (00019), and dysfunctional family processes (00063).

Conclusion

The nursing diagnosis Frail elderly syndrome (00257) was clinically validated among community-dwelling older adults based on a latent class model comprising 17 defining characteristics, all of which demonstrated accuracy, sensitivity, and specificity measures above 85%. Therefore, its assessment is recommended for routine use in Primary Health Care.

Implications for nursing practice

This study demonstrated the diagnostic efficacy for identifying vulnerable older adults within primary healthcare settings, enabling proactive and preventive care interventions for the population.