Instruments to assess frailty in community dwelling older adults: A systematic review

Jananee Rasiah; Andrea Gruneir; Nelly D Oelke; Carole Estabrooks; Jayna Holroyd-Leduc; Greta G Cummings

doi:10.1016/j.ijnurstu.2022.104316

Instruments to assess frailty in community dwelling older adults: A systematic review

Int J Nurs Stud. 2022 Oct:134:104316. doi: 10.1016/j.ijnurstu.2022.104316. Epub 2022 Jun 24.

Authors

Jananee Rasiah¹, Andrea Gruneir², Nelly D Oelke³, Carole Estabrooks⁴, Jayna Holroyd-Leduc⁵, Greta G Cummings⁶

Affiliations

¹ College of Health Sciences, Faculty of Nursing, University of Alberta, 3-141 Edmonton Clinic Health Academy (ECHA), 11405 87 Avenue, Edmonton T6G 1C9, AB, Canada. Electronic address: rasiah@ualberta.ca.
² Faculty of Medicine and Dentistry, 6-10 University Terrace, University of Alberta, Edmonton T6G 2R7, Alberta, Canada. Electronic address: gruneir@ualberta.ca.
³ School of Nursing, Faculty of Health and Social Development, University of British Columbia, Okanagan, 1147 Research Road, Kelowna V1V 1V7, BC, Canada. Electronic address: nelly.oelke@ubc.ca.
⁴ College of Health Sciences, Faculty of Nursing, University of Alberta, 3-141 Edmonton Clinic Health Academy (ECHA), 11405 87 Avenue, Edmonton T6G 1C9, AB, Canada. Electronic address: cestabrooks@ualberta.ca.
⁵ Cumming School of Medicine, University of Calgary, Foothills Medical Centre, 9th Floor North Tower, Room 930, 1403-29 Street NW, Calgary T2N 2T9, Alberta, Canada. Electronic address: jayna.holroyd-leduc@ahs.ca.
⁶ College of Health Sciences, Faculty of Nursing, University of Alberta, 3-141 Edmonton Clinic Health Academy (ECHA), 11405 87 Avenue, Edmonton T6G 1C9, AB, Canada. Electronic address: gretac@ualberta.ca.

PMID: 35863095
DOI: 10.1016/j.ijnurstu.2022.104316

Abstract

Background and objectives: Frailty has been investigated for decades with a proliferation of frailty instruments attributed to many existing conceptual models and operational criteria. The purpose of this systematic review was to understand how instruments were developed to assess frailty in community dwelling older adults.

Research design and methods: This review followed standard conduct, reporting, and quality assessment guidelines. Articles published in English that described instruments used to measure frailty in community dwelling older adults 65 years of age or older; and instruments developed for research purposes or in clinical practice were included. MEDLINE, CINAHL, and EMBASE (March 2022) and Abstracts in Social Gerontology (March 2020) were searched.

Results: A total of 32 frailty instruments were identified with self-reported, performance-based, or researcher/clinician observed items. Common characteristics across instruments were categorized as follows: frailty conceptualized as a state or a syndrome; frailty operationalized as continuous, categorical, or dichotomous; and instruments developed for clinical, research or both purposes. All items in the instruments were developed based on theories of frailty; some were informed by panels of experts; and others used statistical methods to compare variables across instruments.

Discussion and implications: Results from this review will assist clinicians/researchers select appropriate instruments to assess frailty in older adults living in the community. It is time to pause on the development of more instruments. Instead, efforts must be directed toward advancing research and clinical practice using existing validated instruments to inform clinical decision-making and health care coordination to avoid, delay, or manage frailty in the community.

Tweetable abstract: More research and clinical practice using existing validated frailty instruments to assess frailty in older adults living in the community is a must!

Keywords: Community dwelling older adults; Frailty instruments; Systematic review.

Publication types

Review
Systematic Review

MeSH terms

Aged
Frail Elderly
Frailty* / diagnosis
Humans
Independent Living
Self Report