Conclusions The TFI has the most robust evidence of reliability and validity and has been the most extensively examined in terms of psychometric properties .
However , there is insufficient evidence at present to determine the best tool for use in research and clinical practice .
Background Frailty is widely recognised as a distinct multifactorial clinical syndrome that implies vulnerability .
The links between frailty and adverse outcomes such as death and institutionalisation have been widely evidence d. There is currently no gold st and ard frailty assessment tool ; optimizing the assessment of frailty in older people therefore remains a research priority .
The objective of this systematic review is to identify existing multi-component frailty assessment tools that were specifically developed to assess frailty in adults aged ≥60 years old and to systematic ally and critically evaluate the reliability and validity of these tools .
Comparing the Prognostic Accuracy for All-Cause Mortality of Frailty Instruments: A Multicentre 1-Year Follow-Up in Hospitalized Older Patients
Background Frailty is a dynamic age-related condition of increased vulnerability characterized by declines across multiple physiologic systems and associated with an increased risk of death . We compared the predictive accuracy for one-month and one-year all-cause mortality of four frailty instruments in a large population of hospitalized older patients in a prospect i ve multicentre cohort study . Methods and Findings On 2033 hospitalized patients aged ≥65 years from twenty Italian geriatric units , we calculated the frailty indexes derived from the Study of Osteoporotic Fractures ( FI-SOF ) , based on the cumulative deficits model ( FI-CD ) , based on a comprehensive geriatric assessment ( FI-CGA ) , and the Multidimensional Prognostic Index ( MPI ) .  The overall mortality rates were 8.6 % after one-month and 24.9 % after one-year follow-up . All frailty instruments were significantly associated with one-month and one-year all-cause mortality . The areas under the receiver operating characteristic ( ROC ) curves estimated from age- and sex-adjusted logistic regression models , accounting for clustering due to centre effect , showed that the MPI had a significant higher discriminatory accuracy than FI-SOF , FI-CD , and FI-CGA after one month ( areas under the ROC curves : FI-SOF = 0.685 vs. FI-CD = 0.738 vs. FI-CGA = 0.724 vs. MPI = 0.765 , p<0.0001 ) and one year of follow-up ( areas under the ROC curves : FI-SOF = 0.694 vs. FI-CD = 0.729 vs. FI-CGA = 0.727 vs. MPI = 0.750 , p<0.0001 ) . The MPI showed a significant higher discriminatory power for predicting one-year mortality also in hospitalized older patients without functional limitations , without cognitive impairment , malnourished , with increased comorbidity , and with a high number of drugs . Conclusions All frailty instruments were significantly associated with short- and long-term all-cause mortality , but MPI demonstrated a significant higher predictive power than other frailty instruments in hospitalized older patients
Conclusions The TFI has the most robust evidence of reliability and validity and has been the most extensively examined in terms of psychometric properties .
However , there is insufficient evidence at present to determine the best tool for use in research and clinical practice .
Background Frailty is widely recognised as a distinct multifactorial clinical syndrome that implies vulnerability .
The links between frailty and adverse outcomes such as death and institutionalisation have been widely evidence d. There is currently no gold st and ard frailty assessment tool ; optimizing the assessment of frailty in older people therefore remains a research priority .
The objective of this systematic review is to identify existing multi-component frailty assessment tools that were specifically developed to assess frailty in adults aged ≥60 years old and to systematic ally and critically evaluate the reliability and validity of these tools .