Instruments for the detection of frailty syndrome in older adults: A systematic review

Abstract

Frailty is a dynamic process in which there is a reduction in the physical, psychological and/or social function associated with aging. The aim of this study was to identify instruments for the detection of frailty in older adults, characterizing their components, application scenarios, ability to identify pre-frailty and clinimetric properties evaluated. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), under registration number CRD42017039318. A total of 14 electronic sources were searched to identify studies that investigated instruments for the detection of frailty or that presented the construction and/or clinimetric evaluation of the instrument, according to criteria established by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). 96 studies were included in the qualitative synthesis: 51 instruments for the detection of frailty were identified, with predominantly physical domains; 40 were constructed and/or validated for use in the older adult community population, 28 only highlighted the distinction between frail and non-frail individuals and 23 presented three or more levels of frailty. The FRAGIRE, FRAIL Scale, Edmonton Frail Scale and IVCF-20 instruments were the most frequently analyzed in relation to clinimetric properties. It was concluded that: (I) there is a large number of instruments for measuring the same construct, which makes it difficult for researchers and clinicians to choose the most appropriate; (II) the FRAGIRE and CFAI stand out due to their multidimensional aspects, including an environmental assessment; however, (III) the need for standardization of the scales was identified, since the use of different instruments in clinical trials may prevent the comparability of the results in systematic reviews and; (IV) considering the different instruments identified in this review, the choice of researchers/clinicians should be guided by the issues related to the translation and validation for their location and the suitability for their context.

Frailty in very old critically ill patients in Australia and New Zealand: a population‐based cohort study

“…The frailty measure we applied, the CFS, is the most employed frailty instrument in ICUs, and has been validated in a variety of hospital and community health care settings . We have recently reported that the CFS can be used to measure frailty in critical ill patients across the spectrum of health domains, and its performance in ICU patients is comparable with that of comprehensive multidimensional frailty assessment tools .…”

Protein-Related Dietary Parameters and Frailty Status in Older Community-Dwellers across Different Frailty Instruments

“…Although substantial agreement exists on the theoretical construct of frailty, its clinical implementation is hampered by the lack of an unequivocal operational definition. This impasse is reflected by the existence of numerous instruments for frailty assessment, and each of these identifies only partially overlapping phenotypes [7,8].…”

Sex Differences in Frail Older Adults with Foot Pain in a Spanish Population: An Observational Study

“…We can define frailty syndrome as a group of health alterations that can affect several aspects, such as the psychological, biological and social aspects, as it is a consequence of a dynamic process that reduces a person’s health status [ 6 ]. Regarding foot conditions in older adult populations, foot disorders and diseases are present most frequently in the frailty population group, comprising approximately 25% [ 7 , 8 ].…”