Translating and testing feasibility and reliability of the Clinical Frailty Scale for assessing older adults in Greenland

The global population is ageing, contributing to an increase in frailty and increasing pressure on healthcare and rehabilitation systems. The Clinical Frailty Scale (CFS) may be used as a triage tool to guide important clinical decisions and to set goals for care. This study aimed to translate and test the inter-rater reliability and feasibility of CFS for Greenland (CFS-GL), including its relation to demographic factors. CFS-GL was developed under The International Society for Pharmacoeconomics and Outcomes Research guidelines (ISPOR) to ensure conceptual, cultural and linguistic equivalence with translation. The inter-rater reliability was tested using two independent Greenlandic healthcare professionals and a Danish healthcare professional. The data were evaluated using Cohen's kappa and ANOVA. CFS-GL was assessed among 169 participants with a median age of 73 years (interquartile range [IQR] 14). The participants' residences were scattered across Greenland. Inter-rater reliability was very high, with a combined Cohen's kappa of 0.98 (95% CI 0.97-0.99). The median CFS-GL score was 3.9. CFS-GL was associated with residential living, marital status, alcohol intake, outdoor activity, number of medications taken and chronic diseases but was only moderately associated with age. In conclusion, CFS-GL is now available and reliable for Greenland. Future contextual adaptations could improve CFS-GL by detailing Greenlandic activities.