Category: Rating Scales
Objective: The aim of this study was to determine the feasibility of the Clinical Frailty Scale (CFS) as a tool to trigger clinicians’ transfer of care of Parkinson’s patients from neurology to specialist Geriatric medicine services.
Background: The majority of patients with Parkinson’s disease (iPD) in the UK have their care managed by Geriatricians. Frailty services and Geriatricians are well-placed to address the more complex motor, non-motor and neuropsychiatric complications in advanced iPD. The Clinical Frailty Scale is a validated judgement-based tool employed to stratify the burden of frailty in adults.
Method: Consecutive referrals of iPD patients transferred from neurology to a specialist Geriatric Medicine out-patient clinic service over a 3-year period, was reviewed. Only community-dwelling adults with iPD were included. Four experienced clinicians, each blinded to the other’s results, derived a CFS by retrospective analysis of the initial Geriatric Medicine clinic assessment. A single CFS score was then agreed for each individual patient.
Results: 34 patients were included in the study cohort. Every referred patient was appropriate to be seen by the Geriatric medicine iPD clinic, with no referrals declined.
The mean agreed CFS was 5.1 (median 5, mode 6, range 3 to 7). The mean Hoehn & Yahr score was 3 (median 3, mode 3, range 2 to 5).
4/34 (11.8%) patients already had a diagnosis of Parkinson’s disease dementia (PDD) at the time of referral. Another 7/34 (20.6%) patients were given a new diagnosis of PDD at the first Geriatric Medicine clinic assessment.
Conclusion: The results suggest a CFS score of 5 or higher should be used to trigger transfer of care onwards to specialist Geriatric medicine services. Furthermore, the presence of PDD could be used as an adjunct to the CFS trigger.
The next step in this project will be to encourage neurology clinics to complete a CFS on each visit, and evaluate it’s use prospectively in prompting referral to Geriatric medicine. Furthermore, using the CFS as a discriminator, new referrals to neurology with a CFS 5 or more could be fast-tracked directly to Geriatric Medicine.
To cite this abstract in AMA style:
A. Thomson, T. Jones, C. Chan, C. Miller. Utilisation of the Clinical Frailty Scale to prompt transfer of patients with Parkinson’s disease from Neurology to Geriatric Medicine services. [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/utilisation-of-the-clinical-frailty-scale-to-prompt-transfer-of-patients-with-parkinsons-disease-from-neurology-to-geriatric-medicine-services/. Accessed November 10, 2026.« Back to 2022 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/utilisation-of-the-clinical-frailty-scale-to-prompt-transfer-of-patients-with-parkinsons-disease-from-neurology-to-geriatric-medicine-services/