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 .
How should we grade frailty in nursing home patients?
OBJECTIVES To compare 3 methods of describing the frailty of older adults in nursing homes . DESIGN Secondary analysis of a prospect i ve cohort study . SETTING Canadian long-term care institutions . PARTICIPANTS Institutionalized older adults in the second clinical examination cohort of the Canadian Study of Health and Aging ( CSHA-2 ; n = 728 ) . MEASURES Frailty was measured using the Cardiovascular Health Survey definition ( Frail-CHS ) ; the CSHA- Clinical Frailty Scale ( CSHA-CFS ) and a frailty index ( FI ) . RESULTS The sample was very elderly ( 87.7 + /- 6.7 years ) , disabled ( 83 % ) , and showed a high level of mobility impairment ( 83 % ) . Each frailty measure correlated moderately well with each other ( 0.61 - 0.71 ) and with a disability measure ( -0.45 to -0.53 ) but only weakly with age ( 0.13 - 0.19 ) . By each measure , frailty was significantly associated ( P < .01 ) with an increased risk of mortality , disability and cognitive decline . In a model that included both the frailty-CHS definition and the Frailty Index only the latter was associated with a higher risk of mortality ( P < .01 for FI , P = .18 for Frail-CHS ) and decline in the 3MS ( P < .01 for FI , P = .20 for the Frail-CHS definition ) . Both measures were significantly associated with new onset disability ( P < .01 ) . Similar results were found when both the CSHA-CFS and Frailty Index were included in the models . R and om combinations of 15 variables used to make up alternate 5-item Frail-CHS definitions showed that any stratification based on 5 variables allowed tertiles of risk to be discriminated . CONCLUSIONS Frailty is a robust concept and however defined , elderly people who are frail have worse outcomes than those who are not frail . The 3 measures showed varying ability to express grade s of frailty
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 .