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Current Situation of Frailty Screening Tools for Older Adults

The journal of nutrition, health & aging volume 23, pages 111–118 (2019)Cite this article

Abstract

Frailty is a geriatric syndrome associated with adverse outcomes such as falls, disability, and mortality. Frailty is common and contributes to rising health care costs. Early screening and timely tailored intervention may effectively prevent or delay the adverse outcomes in older adults. Studies on frailty and its specific measurement tools are increasing in number, but the debate on the screening instruments remains. Currently, self-reported screening tools can identify frailty and predict the risk of adverse outcomes in older adults. Because they are easy to use and quickly provide information, self-reported frailty screening tools have significant implication in primary care settings and clinics. We reviewed the frailty screening instruments in older adults and proposed a two-step pathway for frailty identification, and to manage declines in intrinsic capacity as well as boost resilience.

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References

  1. World Health Organization. Ageing and health. https://doi.org/www.who.int/news-room/fact-sheets/detail/ageing-and-health. Published 2018. Accessed June 23, 2018.

  2. Mathers CD, Stevens GA, Boerma T, White RA, Tobias MI. Causes of international increases in older age life expectancy. Lancet. 2015;385(9967):540–548. doi:https://doi.org/10.1016/S0140-6736(14)60569-9.

    Article  PubMed  Google Scholar 

  3. Sieliwonczyk E, Perkisas S, Vandewoude M. Frailty indexes, screening instruments and their application in Belgian primary care. Acta Clin Belg. 2014;69(4):233–239. doi:https://doi.org/10.1179/2295333714Y.0000000027.

    Article  CAS  PubMed  Google Scholar 

  4. Azzopardi RV, Vermeiren S, Gorus E, et al. Linking Frailty Instruments to the International Classification of Functioning, Disability, and Health: A Systematic Review. J Am Med Dir Assoc. 2016;17(11):1066.e1–1066.e11. doi:https://doi.org/10.1016/j.jamda.2016.07.023.

    Article  Google Scholar 

  5. Apóstolo J, Cooke R, Bobrowicz-Campos E, et al. Effectiveness of interventions to prevent pre-frailty and frailty progression in older adults. JBI Database Syst Rev Implement Reports. 2018;16(1):140–232. doi:https://doi.org/10.11124/JBISRIR-2017-003382.

    Article  Google Scholar 

  6. Shears M, McGolrick D, Waters B, Jakab M, Boyd JG, Muscedere J. Frailty measurement and outcomes in interventional studies: protocol for a systematic review of randomised control trials. BMJ Open. 2017;7(12):e018872. doi:https://doi.org/10.1136/bmjopen-2017-018872.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Drubbel I, Numans ME, Kranenburg G, Bleijenberg N, de Wit NJ, Schuurmans MJ. Screening for frailty in primary care: a systematic review of the psychometric properties of the frailty index in community-dwelling older people. BMC Geriatr. 2014;14(1):27. doi:https://doi.org/10.1186/1471-2318-14-27.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Gibson JA, Crowe S. Frailty in Critical Care: Examining Implications for Clinical Practices. Crit Care Nurse. 2018;38(3):29–35. doi:https://doi.org/10.4037/ccn2018336.

    Article  PubMed  Google Scholar 

  9. Theou O, Squires E, Mallery K, et al. What do we know about frailty in the acute care setting? A scoping review. BMC Geriatr. 2018;18(1):139. doi:https://doi.org/10.1186/s12877-018-0823-2.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Denfeld QE, Winters-Stone K, Mudd JO, Gelow JM, Kurdi S, Lee CS. The prevalence of frailty in heart failure: A systematic review and meta-analysis. Int J Cardiol. 2017;236:283–289. doi:https://doi.org/10.1016/j.ijcard.2017.01.153.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Van Pilsum Rasmussen S, Konel J, Warsame F, et al. Engaging clinicians and patients to assess and improve frailty measurement in adults with end stage renal disease. BMC Nephrol. 2018;19(1):8. doi:https://doi.org/10.1186/s12882-017-0806-0.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Søndergaard L, Kirk BH, Jørgensen TH. Frailty: An Important Measure in Patients Considered for Transcatheter Aortic Valve Replacement. JACC Cardiovasc Interv. 2018;11(4):404–406. doi:https://doi.org/10.1016/j.jcin.2017.12.017.

    Article  PubMed  Google Scholar 

  13. Sheetz T, Lee CT. Frailty and geriatric assessment in urologic oncology. Curr Opin Urol. 2018;28(3):1. doi:https://doi.org/10.1097/MOU.0000000000000501.

    Article  Google Scholar 

  14. Hogan DB, Maxwell CJ, Afilalo J, et al. A Scoping Review of Frailty and Acute Care in Middle-Aged and Older Individuals with Recommendations for Future Research. Can Geriatr J. 2017;20(1):22–37. doi:https://doi.org/10.5770/cgj.20.240.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Bouillon K, Kivimaki M, Hamer M, et al. Measures of frailty in population-based studies: an overview. BMC Geriatr. 2013;13(1):64. doi:https://doi.org/10.1186/1471-2318-13-64.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Sternberg SA, Schwartz AW, Karunananthan S, Bergman H, Mark Clarfield A. The Identification of Frailty: A Systematic Literature Review. J Am Geriatr Soc. 2011;59(11):2129–2138. doi:https://doi.org/10.1111/j.1532-5415.2011.03597.x.

    Article  PubMed  Google Scholar 

  17. de Vries NM, Staal JB, van Ravensberg CD, Hobbelen JSM, Olde Rikkert MGM, Nijhuis-van der Sanden MWG. Outcome instruments to measure frailty: A systematic review. Ageing Res Rev. 2011;10(1):104–114. doi:https://doi.org/10.1016/j.arr.2010.09.001.

    Article  CAS  PubMed  Google Scholar 

  18. Clegg A, Rogers L, Young J. Diagnostic test accuracy of simple instruments for identifying frailty in community-dwelling older people: a systematic review. Age Ageing. 2015;44(1):148–152. doi:https://doi.org/10.1093/ageing/afu157.

    Article  PubMed  Google Scholar 

  19. Buta BJ, Walston JD, Godino JG, et al. Frailty assessment instruments: Systematic characterization of the uses and contexts of highly-cited instruments. Ageing Res Rev. 2016;26:53–61. doi:https://doi.org/10.1016/j.arr.2015.12.003.

    Article  PubMed  Google Scholar 

  20. Fried LP, Tangen CM, Walston J, et al. Frailty in Older Adults: Evidence for a Phenotype. Journals Gerontol Ser A Biol Sci Med Sci. 2001;56(3):M146–M157. doi:https://doi.org/10.1093/gerona/56.3.M146.

    Article  CAS  Google Scholar 

  21. Morley JE, Vellas B, Abellan van Kan G, et al. Frailty consensus: A call to action. J Am Med Dir Assoc. 2013;14(6):392–397. doi:https://doi.org/10.1016/j.jamda.2013.03.022.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Dent E, Lien C, Lim WS, et al. The Asia-Pacific Clinical Practice Guidelines for the Management of Frailty. J Am Med Dir Assoc. 2017;18(7):564–575. doi:https://doi.org/10.1016/j.jamda.2017.04.018.

    Article  PubMed  Google Scholar 

  23. Mitnitski AB, Mogilner AJ, Rockwood K. Accumulation of Deficits as a Proxy Measure of Aging. Sci World J. 2001;1:323–336. doi:https://doi.org/10.1100/tsw.2001.58.

    Article  CAS  Google Scholar 

  24. Rockwood K, Hogan DB, MacKnight C. Conceptualisation and Measurement of Frailty in Elderly People. Drugs Aging. 2000;17(4):295–302. doi:https://doi.org/10.2165/00002512-200017040-00005.

    Article  CAS  PubMed  Google Scholar 

  25. Hogan DB, MacKnight C, Bergman H, Steering Committee, Canadian Initiative on Frailty and Aging. Models, definitions, and criteria of frailty. Aging Clin Exp Res. 2003;15(3 Suppl):1–29. https://doi.org/www.ncbi.nlm.nih.gov/pubmed/14580013. Accessed June 22, 2018.

    PubMed  Google Scholar 

  26. Rockwood K, Fox RA, Stolee P, Robertson D, Beattie BL. Frailty in elderly people: an evolving concept. CMAJ. 1994;150(4):489–495. https://doi.org/www.ncbi.nlm.nih.gov/pubmed/8313261. Accessed June 22, 2018.

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Bergman H, Ferrucci L, Guralnik J, et al. Frailty: an emerging research and clinical paradigm—issues and controversies. J Gerontol A Biol Sci Med Sci. 2007;62(7):731–737. https://doi.org/ncbi.nlm.nih.gov/pubmed/17634320. Accessed October 15, 2017.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Rodríguez-Mañas L, Féart C, Mann G, et al. Searching for an operational definition of frailty: a Delphi method based consensus statement: the frailty operative definitionconsensus conference project. J Gerontol A Biol Sci Med Sci. 2013;68(1):62–67. doi:https://doi.org/10.1093/gerona/gls119.

    Article  PubMed  Google Scholar 

  29. Makizako H, Shimada H, Tsutsumimoto K, et al. Social Frailty in Community-Dwelling Older Adults as a Risk Factor for Disability. J Am Med Dir Assoc. 2015;16(11):1003.e7–1003.e11. doi:https://doi.org/10.1016/j.jamda.2015.08.023.

    Article  Google Scholar 

  30. Ma L, Sun F, Tang Z. Social Frailty is Associated with Physical Functioning, Cognition, and Depression, and Predicts Mortality. J Nutr Health Aging. June 2018:1–7. doi:https://doi.org/10.1007/s12603-018-1054-0.

    Google Scholar 

  31. Subra J, Gillette-Guyonnet S, Cesari M, Oustric S, Vellas B, Platform Team. The integration of frailty into clinical practice: preliminary results from the Gérontopôle. J Nutr Health Aging. 2012;16(8):714–720. doi:https://doi.org/10.1007/s12603-012-0391-7.

    Article  CAS  PubMed  Google Scholar 

  32. Cesari M, Araujo de Carvalho I, Amuthavalli Thiyagarajan J, et al. Evidence for the Domains Supporting the Construct of Intrinsic Capacity. Journals Gerontol Ser A. February 2018. doi:https://doi.org/10.1093/gerona/gly011.

    Google Scholar 

  33. Hadley EC, Kuchel GA, Newman AB, et al. Report: NIA Workshop on Measures of Physiologic Resiliencies in Human Aging. Journals Gerontol Ser A. 2017;72(7):980–990. doi:https://doi.org/10.1093/gerona/glx015.

    Article  Google Scholar 

  34. LeBrasseur NK. Physical Resilience: Opportunities and Challenges in Translation. Journals Gerontol Ser A. 2017;72(7):978–979. doi:https://doi.org/10.1093/gerona/glx028.

    Article  CAS  Google Scholar 

  35. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381(9868):752–762. doi:https://doi.org/10.1016/S0140-6736(12)62167-9.

    Article  PubMed  Google Scholar 

  36. Ma L, Zhang L, Tang Z, et al. Use of the frailty index in evaluating the prognosis of older people in Beijing: A cohort study with an 8-year follow-up. Arch Gerontol Geriatr. 2016;64(3):172–177. doi:https://doi.org/10.1016/j.archger.2015.11.002.

    Article  PubMed  Google Scholar 

  37. Ma L, Tang Z, Chan P, Walston J. Novel Frailty Screening Questionnaire (FSQ) Predicts 8-year Mortality in Older Adults in China. J Frailty Aging. 2018;In press.

    Google Scholar 

  38. Mousa A, Savva GM, Mitnitski A, et al. Is frailty a stable predictor of mortality across time? Evidence from the Cognitive Function and Ageing Studies. Age Ageing. June 2018. doi:https://doi.org/10.1093/ageing/afy077.

    Google Scholar 

  39. Makizako H, Shimada H, Doi T, Tsutsumimoto K, Suzuki T. Impact of physical frailty on disability in community-dwelling older adults: a prospective cohort study. BMJ Open. 2015;5(9):e008462. doi:https://doi.org/10.1136/bmjopen-2015-008462.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Cheng M-H, Chang S-F. Frailty as a Risk Factor for Falls Among Community Dwelling People: Evidence From a Meta-Analysis. J Nurs Scholarsh. 2017;49(5):529–536. doi:https://doi.org/10.1111/jnu.12322.

    Article  PubMed  Google Scholar 

  41. Zheng Z, Guan S, Ding H, et al. Prevalence and Incidence of Frailty in Community-Dwelling Older People: Beijing Longitudinal Study of Aging II. J Am Geriatr Soc. 2016;64(6):1281–1286. doi:https://doi.org/10.1111/jgs.14135.

    Article  PubMed  Google Scholar 

  42. Inouye SK, Studenski S, Tinetti ME, Kuchel GA. Geriatric Syndromes: Clinical, Research, and Policy Implications of a Core Geriatric Concept. J Am Geriatr Soc. 2007;55(5):780–791. doi:https://doi.org/10.1111/j.1532-5415.2007.01156.x.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Lee L, Heckman G, Molnar FJ. Frailty: Identifying elderly patients at high risk of poor outcomes. Can Fam Physician. 2015;61(3):227–231. https://doi.org/www.ncbi.nlm.nih.gov/pubmed/25767167. Accessed June 3, 2018.

    PubMed  PubMed Central  Google Scholar 

  44. Szewieczek J, Bieniek J, Wilczynski K. Fried frailty phenotype assessment components as applied to geriatric inpatients. Clin Interv Aging. 2016;11:453. doi:https://doi.org/10.2147/CIA.S101369.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Op het Veld LPM, van Rossum E, Kempen GIJM, de Vet HCW, Hajema K, Beurskens AJHM. Fried phenotype of frailty: cross-sectional comparison of three frailty stages on various health domains. BMC Geriatr. 2015;15(1):77. doi:https://doi.org/10.1186/s12877-015-0078-0.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Ensrud KE, Ewing SK, Taylor BC, et al. Frailty and Risk of Falls, Fracture, and Mortality in Older Women: The Study of Osteoporotic Fractures. Journals Gerontol Ser A Biol Sci Med Sci. 2007;62(7):744–751. doi:https://doi.org/10.1093/gerona/62.7.744.

    Article  Google Scholar 

  47. Bilotta C, Nicolini P, Casè A, Pina G, Rossi S, Vergani C. Frailty syndrome diagnosed according to the Study of Osteoporotic Fractures (SOF) criteria and adverse health outcomes among community-dwelling older outpatients in Italy. A one-year prospective cohort study. Arch Gerontol Geriatr. 2012;54(2):e23–8. doi:https://doi.org/10.1016/j.archger.2011.06.037.

    Article  PubMed  Google Scholar 

  48. Dent E, Perez-Zepeda M. Comparison of five indices for prediction of adverse outcomes in hospitalised Mexican older adults: a cohort study. Arch Gerontol Geriatr. 2015;60(1):89–95. doi:https://doi.org/10.1016/j.archger.2014.09.011.

    Article  PubMed  Google Scholar 

  49. Romero-Ortuno R, Soraghan C. A Frailty Instrument for primary care for those aged 75 years or more: findings from the Survey of Health, Ageing and Retirement in Europe, a longitudinal population-based cohort study (SHARE-FI75+). BMJ Open. 2014;4(12):e006645. doi:https://doi.org/10.1136/bmjopen-2014-006645.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Kim DH, Schneeweiss S, Glynn RJ, Lipsitz LA, Rockwood K, Avorn J. Measuring Frailty in Medicare Data: Development and Validation of a Claims-Based Frailty Index. Journals Gerontol Ser A. December 2017. doi:https://doi.org/10.1093/gerona/glx229.

    Google Scholar 

  51. Ruiz JG, Priyadarshni S, Rahaman Z, et al. Validation of an automatically generated screening score for frailty: the care assessment need (CAN) score. BMC Geriatr. 2018;18(1):106. doi:https://doi.org/10.1186/s12877-018-0802-7.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Studenski S, Perera S, Patel K. Gait speed and survival in older adults. JAMA. 2011;305(1):50–58. doi:https://doi.org/10.1001/jama.2010.1923.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Jung H-W, Jang I-Y, Lee CK, et al. Usual gait speed is associated with frailty status, institutionalization, and mortality in community-dwelling rural older adults: a longitudinal analysis of the Aging Study of Pyeongchang Rural Area. Clin Interv Aging. 2018;Volume 13:1079–1089. doi:https://doi.org/10.2147/CIA.S166863.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Pamoukdjian F, Paillaud E, Zelek L, et al. Measurement of gait speed in older adults to identify complications associated with frailty: A systematic review. J Geriatr Oncol. 2015;6(6):484–496. doi:https://doi.org/10.1016/j.jgo.2015.08.006.

    Article  PubMed  Google Scholar 

  55. Ma L, Wang J, Tang Z, Chan P. Simple Physical Activity Index Predicts Prognosis in Older Adults: Beijing Longitudinal Study of Aging. J Nutr Health Aging. April 2018:1–7. doi:https://doi.org/10.1007/s12603-018-1037-1.

    Google Scholar 

  56. Pilotto A, Rengo F, Marchionni N, et al. Comparing the Prognostic Accuracy for All-Cause Mortality of Frailty Instruments: A Multicentre 1-Year Follow-Up in Hospitalized Older Patients. Vina J, ed. PLoS One. 2012;7(1):e29090. doi:https://doi.org/10.1371/journal.pone.0029090.

    Article  CAS  Google Scholar 

  57. Pilotto A, Addante F, Franceschi M, et al. Multidimensional Prognostic Index based on a comprehensive geriatric assessment predicts short-term mortality in older patients with heart failure. Circ Heart Fail. 2010;3(1):14–20. doi:https://doi.org/10.1161/CIRCHEARTFAILURE.109.865022.

    Article  PubMed  Google Scholar 

  58. Angleman SB, Santoni G, Pilotto A, Fratiglioni L, Welmer A-K, MPI_AGE Project Investigators. Multidimensional Prognostic Index in Association with Future Mortality and Number of Hospital Days in a Population-Based Sample of Older Adults: Results of the EU Funded MPI_AGE Project. Sergi G, ed. PLoS One. 2015;10(7):e0133789. doi:https://doi.org/10.1371/journal.pone.0133789.

    Article  CAS  Google Scholar 

  59. Mangoni AA. Using the multidimensional prognostic index for treatment decisions and monitoring in frail older patients. Geriatr Care. 2017;3(3). doi:https://doi.org/10.4081/gc.2017.7059.

    Google Scholar 

  60. Rolfson DB, Majumdar SR, Tsuyuki RT, Tahir A, Rockwood K. Validity and reliability of the Edmonton Frail Scale. Age Ageing. 2006;35(5):526–529. doi:https://doi.org/10.1093/ageing/afl041.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Perna S, Francis MD, Bologna C, et al. Performance of Edmonton Frail Scale on frailty assessment: its association with multi-dimensional geriatric conditions assessed with specific screening tools. BMC Geriatr. 2017;17(1):2. doi:https://doi.org/10.1186/s12877-016-0382-3.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Blanco S, Ferrières J, Bongard V, et al. Prognosis Impact of Frailty Assessed by the Edmonton Frail Scale in the Setting of Acute Coronary Syndrome in the Elderly. Can J Cardiol. 2017;33(7):933–939. doi:https://doi.org/10.1016/j.cjca.2017.03.026.

    Article  PubMed  Google Scholar 

  63. Rose M, Yang A, Welz M, Masik A, Staples M. Novel modification of the Reported Edmonton Frail Scale. Australas J Ageing. April 2018. doi:https://doi.org/10.1111/ajag.12533.

    Google Scholar 

  64. Hilmer S, Perera V, Mitchell S. The assessment of frailty in older people in acute care. J ageing. 2009. https://doi.org/onlinelibrary.wiley.com/doi/10.1111/j.1741-6612.2009.00367.x/full. Accessed June 12, 2017.

    Google Scholar 

  65. Evans SJ, Sayers M, Mitnitski A, Rockwood K. The risk of adverse outcomes in hospitalized older patients in relation to a frailty index based on a comprehensive geriatric assessment. Age Ageing. 2014;43(1):127–132. doi:https://doi.org/10.1093/ageing/aft156.

    Article  PubMed  Google Scholar 

  66. Goldstein J, Hubbard RE, Moorhouse P, Andrew MK, Mitnitski A, Rockwood K. The validation of a care partner-derived frailty index based upon comprehensive geriatric assessment (CP-FI-CGA) in emergency medical services and geriatric ambulatory care. Age Ageing. 2015;44(2):327–330. doi:https://doi.org/10.1093/ageing/afu161.

    Article  PubMed  Google Scholar 

  67. Khatry K, Peel NM, Gray LC, Hubbard RE. The Utility of the Frailty Index in Clinical Decision Making. J frailty aging. 2018;7(2):138–141. doi:https://doi.org/10.14283/jfa.2018.7.

    CAS  PubMed  Google Scholar 

  68. Ma L, Tang Z, Zhang L, Sun F, Li Y, Chan P. Prevalence of Frailty and Associated Factors in the Community-Dwelling Population of China. J Am Geriatr Soc. 2018;66(3):559–564. doi:https://doi.org/10.1111/jgs.15214.

    Article  PubMed  Google Scholar 

  69. Ma L, Zhang L, Zhang Y, et al. Cognitive Frailty in China: Results from China Comprehensive Geriatric Assessment Study. Front Med. 2017;4:174. doi:https://doi.org/10.3389/fmed.2017.00174.

    Article  Google Scholar 

  70. Afilalo J, Alexander K, Mack M, Maurer M. Frailty assessment in the cardiovascular care of older adults. J Am. 2014. https://doi.org/www.sciencedirect.com/science/article/pii/S073510971306155X. Accessed June 12, 2017.

    Google Scholar 

  71. Rockwood K, Song X, MacKnight C. A global clinical measure of fitness and frailty in elderly people. Can Med. 2005. https://doi.org/www.cmaj.ca/content/173/5/489.short. Accessed June 12, 2017.

    Google Scholar 

  72. Shears M, Takaoka A, Rochwerg B, et al. Assessing frailty in the intensive care unit: A reliability and validity study. J Crit Care. 2018;45:197–203. doi:https://doi.org/10.1016/j.jcrc.2018.02.004.

    Article  PubMed  Google Scholar 

  73. Basic D, Shanley C. Frailty in an older inpatient population: using the clinical frailty scale to predict patient outcomes. J Aging Health. 2015;27(4):670–685. doi:https://doi.org/10.1177/0898264314558202.

    Article  PubMed  Google Scholar 

  74. Vellas B, Balardy L, Gillette-Guyonnet S, et al. Looking for frailty in communitydwelling older persons: The Gerontopole Frailty Screening Tool (GFST). J Nutr Health Aging. 2013;17(7):629–631. doi:https://doi.org/10.1007/s12603-013-0363-6.

    Article  CAS  PubMed  Google Scholar 

  75. Cesari M, Demougeot L, Boccalon H, et al. A self-reported screening tool for detecting community-dwelling older persons with frailty syndrome in the absence of mobility disability: The FiND questionnaire. PLoS One. 2014;9(7). doi:https://doi.org/10.1371/journal.pone.0101745.

    Google Scholar 

  76. Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Heal Aging. 2012;16(7):601–608.

    Article  CAS  Google Scholar 

  77. Gobbens RJJ, van Assen MALM, Luijkx KG, Wijnen-Sponselee MT, Schols JMGA. The Tilburg Frailty Indicator: Psychometric Properties. J Am Med Dir Assoc. 2010;11(5):344–355. doi:https://doi.org/10.1016/j.jamda.2009.11.003.

    Article  PubMed  Google Scholar 

  78. Papachristou E, Wannamethee SGS, Lennon LT, et al. Ability of Self-Reported Frailty Components to Predict Incident Disability, Falls, and All-Cause Mortality: Results From a Population-Based Study of Older British Men. J Am Med Dir Assoc. 2017;18(2):152–157. doi:https://doi.org/10.1016/j.jamda.2016.08.020.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Nunes DP, Duarte YA de O, Santos JLF, Lebrão ML. Screening for frailty in older adults using a self-reported instrument. Rev Saude Publica. 2015;49(1). doi:https://doi.org/10.1590/S0034-8910.2015049005516.

    Google Scholar 

  80. Kapoor A, Matheos T, Walz M, et al. Self-Reported Function More Informative than Frailty Phenotype in Predicting Adverse Postoperative Course in Older Adults. J Am Geriatr Soc. 2017;65(11):2522–2528. doi:https://doi.org/10.1111/jgs.15108.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Aprahamian I, Cezar NO de C, Izbicki R, et al. Screening for Frailty With the FRAIL Scale: A Comparison With the Phenotype Criteria. J Am Med Dir Assoc. 2017. doi:https://doi.org/10.1016/j.jamda.2017.01.009.

    Google Scholar 

  82. Gardiner PA, Mishra GD, Dobson AJ. Validity and responsiveness of the FRAIL scale in a longitudinal cohort study of older Australian women. J Am Med Dir Assoc. 2015;16(9):781–783. doi:https://doi.org/10.1016/j.jamda.2015.05.005.

    Article  PubMed  Google Scholar 

  83. Dong L, Qiao X, Tian X, et al. Cross-Cultural Adaptation and Validation of the FRAIL Scale in Chinese Community-Dwelling Older Adults. J Am Med Dir Assoc. 2018;19:12–17. doi:https://doi.org/10.1016/j.jamda.2017.06.011.

    Article  PubMed  Google Scholar 

  84. Chao C Ter, Hsu YH, Chang PY, et al. Simple self-report FRAIL scale might be more closely associated with dialysis complications than other frailty screening instruments in rural chronic dialysis patients. Nephrology. 2015;20(5):321–328. doi:https://doi.org/10.1111/nep.12401.

    Article  PubMed  Google Scholar 

  85. Gobbens RJ, van Assen MA, Luijkx KG, Schols JM. Testing an integral conceptual model of frailty. J Adv Nurs. 2012;68(9):2047–2060. doi:https://doi.org/10.1111/j.1365-2648.2011.05896.x.

    Article  PubMed  Google Scholar 

  86. Gobbens R, Schols J, van Assen M. Exploring the efficiency of the Tilburg Frailty Indicator: a review. Clin Interv Aging. 2017;Volume 12:1739–1752. doi:https://doi.org/10.2147/CIA.S130686.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Peters LL, Boter H, Buskens E, Slaets JPJ. Measurement properties of the Groningen Frailty Indicator in home-dwelling and institutionalized elderly people. J Am Med Dir Assoc. 2012;13(6):546–551. doi:https://doi.org/10.1016/j.jamda.2012.04.007.

    Article  PubMed  Google Scholar 

  88. Drubbel I, Bleijenberg N, Kranenburg G, et al. Identifying frailty: do the Frailty Index and Groningen Frailty Indicator cover different clinical perspectives? a cross-sectional study. BMC Fam Pract. 2013;14(1):64. doi:https://doi.org/10.1186/1471-2296-14-64.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Demougeot L, van Kan GA, Vellas B, de Souto Barreto P. Frailty Detection with the Gérontopôle Frailty Screening Tool (GFST). J frailty aging. 2013;2(3):150–152. doi:https://doi.org/10.14283/jfa.2013.22.

    CAS  PubMed  Google Scholar 

  90. Daniels R, van Rossum E, Beurskens A, van den Heuvel W, de Witte L. The predictive validity of three self-report screening instruments for identifying frail older people in the community. BMC Public Health. 2012;12(1):69. doi:https://doi.org/10.1186/1471-2458-12-69.

    Article  PubMed  PubMed Central  Google Scholar 

  91. Raîche M, Hébert R, Dubois M-F. PRISMA-7: a case-finding tool to identify older adults with moderate to severe disabilities. Arch Gerontol Geriatr. 2008;47(1):9–18. doi:https://doi.org/10.1016/j.archger.2007.06.004.

    Article  PubMed  Google Scholar 

  92. Saenger-ALF, Caldas CP, Raîche M, da Motta LB. Identifying the loss of functional independence of older people residing in the community: Validation of the PRISMA-7 instrument in Brazil. Arch Gerontol Geriatr. 2018;74:62–67. doi:https://doi.org/10.1016/j.archger.2017.09.008.

    Article  PubMed  Google Scholar 

  93. Elliott A, Phelps K, Regen E, Conroy SP. Identifying frailty in the Emergency Department—feasibility study. Age Ageing. 2017;46(5):840–845. doi:https://doi.org/10.1093/ageing/afx089.

    Article  PubMed  Google Scholar 

  94. Rockwood K, Theou O, Mitnitski A. What are frailty instruments for? Age Ageing. 2015;44(4):545–547. doi:https://doi.org/10.1093/ageing/afv043.

    Article  PubMed  Google Scholar 

  95. van Kempen JAL, Schers HJ, Melis RJF, Olde Rikkert MGM. Construct validity and reliability of a two-step tool for the identification of frail older people in primary care. J Clin Epidemiol. 2014;67(2):176–183. doi:https://doi.org/10.1016/j.jclinepi.2013.08.008.

    Article  PubMed  Google Scholar 

  96. van Kempen JAL, Schers HJ, Philp I, Olde Rikkert MGM, Melis RJF. Predictive validity of a two-step tool to map frailty in primary care. BMC Med. 2015;13(1):287. doi:https://doi.org/10.1186/s12916-015-0519-9.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Gilardi F, Capanna A, Ferraro M, et al. Frailty screening and assessment tools: a review of characteristics and use in Public Health. Ann Ig. 2018;30:128–139. doi:https://doi.org/10.7416/ai.2018.2204.

    CAS  PubMed  Google Scholar 

  98. Barreto P de S, Greig C, Ferrandez AAM. Detecting and categorizing frailty status in older adults using a self-report screening instrument. Arch Gerontol Geriatr. 2012;54(3):249–254. doi:https://doi.org/10.1016/j.archger.2011.08.003.

    Article  Google Scholar 

  99. Bao Y, Dalrymple L, Chertow GM, Kaysen GA, Johansen KL. Frailty, Dialysis Initiation, and Mortality in End-Stage Renal Disease. Arch Intern Med. 2012;172(14). doi:https://doi.org/10.1001/archinternmed.2012.3020.

    Google Scholar 

  100. Johansen KL, Chertow GM, Jin C, Kutner NG. Significance of frailty among dialysis patients. J Am Soc Nephrol. 2007;18(11):2960–2967. doi:https://doi.org/10.1681/ASN.2007020221.

    Article  PubMed  Google Scholar 

  101. Walston J. Frailty Research Moves Beyond Risk Assessment. Journals Gerontol Ser A. 2017;72(7):915–916. doi:https://doi.org/10.1093/gerona/glx085.

    Article  Google Scholar 

  102. Turner G, Clegg A. Best practice guidelines for the management of frailty: a British Geriatrics Society, Age UK and Royal College of General Practitioners report. Age Ageing. 2014;43(6):744–747. doi:https://doi.org/10.1093/ageing/afu138.

    Article  PubMed  Google Scholar 

  103. Xue Q-L, Varadhan R. What Is Missing in the Validation of Frailty Instruments? J Am Med Dir Assoc. 2014;15(2):141–142. doi:https://doi.org/10.1016/J.JAMDA.2013.11.007.

    Article  PubMed  Google Scholar 

  104. Johansen KL, Dalrymple LS, Delgado C, et al. Comparison of Self-report-Based and Physical Performance-Based Frailty Definitions Among Patients Receiving Maintenance Hemodialysis. Am J Kidney Dis. 2014;64(4):600–607. doi:https://doi.org/10.1053/J.AJKD.2014.03.016.

    Article  PubMed  PubMed Central  Google Scholar 

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  1. Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, 45 Changchun Street, Xicheng District, Beijing, 100053, China

    Lina Ma

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Ma, L. Current Situation of Frailty Screening Tools for Older Adults. J Nutr Health Aging 23, 111–118 (2019). https://doi.org/10.1007/s12603-018-1123-4

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Key words

  • Frailty
  • screening tool
  • older adults
  • intrinsic capacity