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Review
. 2016 Mar:26:53-61.
doi: 10.1016/j.arr.2015.12.003. Epub 2015 Dec 7.

Frailty assessment instruments: Systematic characterization of the uses and contexts of highly-cited instruments

Brian J Buta  1 , Jeremy D Walston  1 , Job G Godino  2 , Minsun Park  3 , Rita R Kalyani  1 , Qian-Li Xue  1 , Karen Bandeen-Roche  4 , Ravi Varadhan  5
Affiliations
Review

Frailty assessment instruments: Systematic characterization of the uses and contexts of highly-cited instruments

Brian J Buta et al. Ageing Res Rev. 2016 Mar.

Abstract

The medical syndrome of frailty is widely recognized, yet debate remains over how best to measure it in clinical and research settings. This study reviewed the frailty-related research literature by (a) comprehensively cataloging the wide array of instruments that have been utilized to measure frailty, and (b) systematically categorizing the different purposes and contexts of use for frailty instruments frequently cited in the research literature. We identified 67 frailty instruments total; of these, nine were highly-cited (≥ 200 citations). We randomly sampled and reviewed 545 English-language articles citing at least one highly-cited instrument. We estimated the total number of uses, and classified use into eight categories: risk assessment for adverse health outcomes (31% of all uses); etiological studies of frailty (22%); methodology studies (14%); biomarker studies (12%); inclusion/exclusion criteria (10%); estimating prevalence as primary goal (5%); clinical decision-making (2%); and interventional targeting (2%). The most common assessment context was observational studies of older community-dwelling adults. Physical Frailty Phenotype was the most used frailty instrument in the research literature, followed by the Deficit Accumulation Index and the Vulnerable Elders Survey. This study provides an empirical evaluation of the current uses of frailty instruments, which may be important to consider when selecting instruments for clinical or research purposes. We recommend careful consideration in the selection of a frailty instrument based on the intended purpose, domains captured, and how the instrument has been used in the past. Continued efforts are needed to study the validity and feasibility of these instruments.

Keywords: Frailty assessment; Instrument; Operational definition; Review.

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Figures

Fig. 1
Fig. 1
Cumulative number of articles that cite the Most-Referenced Frailty Instruments. This figure displays the cumulative number of citations (on the Y-Axis) per year (on the X-Axis) for nine highly-cited frailty instruments. The Y-axis is on a logarithmic scale. The Physical Frailty Phenotype is the most cited frailty instrument (1891); Deficit Accumulation Index is the second most cited (401).
Fig. 2
Fig. 2
Frailty Instruments and Categories of Use, Ordered by Number of Estimated Uses per Category. This figure displays the percentage of use per category, and the number of estimated uses of the highly-cited frailty instruments per each category.
See this image and copyright information in PMC

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