Tesis

Pengaruh Frailty Berdasarkan Clinical Frailty Scale Terhadap Perubahan Status Fungsional pada Pasien Geriatri Rawat Jalan = The Influence of Frailty Based on the Clinical Frailty Scale on Functional Status Changes in Geriatric Outpatients.

Latar Belakang: Frailty merupakan sindrom klinis yang berkaitan dengan peningkatan kerentanan dan risiko penurunan status fungsional. Clinical frailty scale (CFS) adalah instrumen penilaian frailty yang praktis dan sudah divalidasi dan direkomendasikan di Asia-Pasifik, namun belum banyak digunakan di Indonesia, khususnya dalam studi longitudinal di setting rawat jalan. Tujuan: Penelitian ini bertujuan untuk menganalisis pengaruh frailty berdasarkan CFS terhadap perubahan status fungsional (diukur dengan skor Barthel) pada pasien geriatri rawat jalan. Metode: Penelitian kohort prospektif ini dilakukan di Poliklinik Geriatri RSCM dari Januari hingga Agustus 2025. Frailty dinilai dengan CFS pada baseline, sedangkan status fungsional dinilai dengan skor Barthel pada baseline, bulan ke-1, dan bulan ke-3. Analisis data menggunakan Generalized Linear Model. Hasil: Dari 160 subjek yang dianalisis, sebanyak 53,1% subjek tergolong robust (CFS 1 -3), 31,3% subjek frail sangat ringan-ringan (CFS 4-5), dan 15,6% subjek frail (CFS 6-9). Secara statistik, terdapat hubungan yang signifikan antara kategori CFS dengan skor Barthel pada semua waktu pengukuran (p < 0,0001), dimana kelompok frail memiliki skor Barthel yang lebih rendah, namun, analisis perubahan skor Barthel (delta) dari waktu ke waktu tidak menunjukkan perbedaan yang signifikan antar kelompok CFS selama 3 bulan (p > 0,05). Kesimpulan: Secara statistik, frailty berdasarkan CFS berhubungan signifikan dengan status fungsional dasar (skor Barthel) yang lebih rendah pada pasien geriatri rawat jalan, namun dalam periode observasi 3 bulan yang singkat, tidak terdeteksi perubahan status fungsional yang bermakna. Clinical frailty scale direkomendasikan sebagai alat skrining untuk stratifikasi risiko di poliklinik geriatri.
Kata kunci: Clinical frailty scale, Frailty, Skor Barthel, Status fungsional


Background: Frailty is a clinical syndrome associated with increased vulnerability and risk of functional decline. The Clinical frailty scale (CFS) is a practical tool for assessing frailty, but longitudinal evidence in the Indonesian outpatient setting remains limited. Objective: This study aims to analyze the influence of frailty based on CFS on functional status changes (measured by the Barthel Index/BI) in geriatric outpatients. Methods: This prospective cohort study was conducted at the Geriatric Outpatient Clinic of RSCM from January to August 2025. A total of 160 subjects aged ≥60 years were recruited consecutively. Frailty was assessed using CFS at baseline, while functional status was assessed using Barthel score at baseline, 1 -month, and 3-month follow-ups. Data analysis employed the Generalized Linear Model. Results: A total of 160 subjects, 53.1% were classified as robust (CFS 1 -3), 31.3% as mildly/very mildly frail (CFS 4-5), and 15.6% as frail (CFS 6-9). A significant association was found between CFS categories and Barthel score at all measurement times (p < 0.0001), with the frail group having lower Barthel score. However, the analysis of changes in Barthel score (delta) over time showed no significant difference between CFS groups over the 3-month period (p > 0.05). Confounding variables such as malnutrition, depression, polypharmacy, history of falls, and medical rehabilitation programs did not significantly influence this relationship. Conclusion: Frailty based on CFS is significantly associated with lower baseline functional status (Barthel score) in geriatric outpatients. However, no significant functional status change was detected during the short 3-month observation period. Clinical frailty scale is recommended as a screening tool for risk stratification in geriatric clinics.
Keyword: Clinical Frailty Scale, Frailty, Barthel score, Functional Status