The Frailty Index was examined in almost all these dimensions , with the exception of reliability , and its diagnostic and predictive characteristics were shown to be satisfactory .
Gait speed showed high sensitivity , but only moderate specificity , and excellent predictive ability for future disability in activities of daily living .
The Tilburg Frailty Indicator was shown to be a reliable and valid measure for frailty screening , but its diagnostic accuracy was not evaluated .
Screening Letter , Timed-up- and -go test and PRISMA 7 ( Preferred Reporting Items for Systematic Review s and Meta-Analyses ) demonstrated high sensitivity and moderate specificity for identifying frailty .
In general , low physical activity , variously measured , was one of the most powerful predictors of future decline in activities of daily living .
Conclusion Only a few frailty measures seem to be demonstrably valid , reliable and diagnostically accurate , and have good predictive ability .
Nevertheless , it was clear that no suitable tool for assessing frailty appropriately in emergency departments was identified
Background A scoping search identified systematic review s on diagnostic accuracy and predictive ability of frailty measures in older adults .
In most cases , research was confined to specific assessment measures related to a specific clinical model .
Objectives To summarize the best available evidence from systematic review s in relation to reliability , validity , diagnostic accuracy and predictive ability of frailty measures in older adults .
Usefulness of frailty profile for targeting older heart failure patients in disease management programs: a cost-effectiveness, pilot study
Background Disease management programs ( DMP ) improve outcomes in patients with heart failure . Because older heart failure patients represent a heterogeneous population , the aim of this study was to determine which patients benefit mostly from a DMP , by means of their frailty profile . Setting Heart failure outpatient clinic . Methods Consecutive ( n = 173 ) patients aged more than 70 years were r and omized to a  multidisciplinary DMP  ( n = 86 ) or usual care ( n = 87 ) . A modified frailty score ( range 1–6 ) was used as an index of global functional impairment . Results Mild to moderate frailty ( frailty score = 2–3 ) was associated with significant improvements in outcomes ( death and /or heart failure admission , heart failure admissions and all-cause admissions ) in DMP patients vs. usual care . Even in more frail patients ( frailty score = 4–6 ) a significant reduction in heart failure admissions was observed . By contrast , nonfrail patients ( frailty score = 1 ) did not derive significant benefit . In the cost-effectiveness analysis , the mean savings per patient , stratified according to their frailty score , were & U20AC ; −1003.31 for frailty score 1 ( 95 % confidence interval −3717.00–1709.00 ) , & U20AC ; 1104.72 for frailty score 2 ( −280.6–2491.00 ) , & U20AC ; 2635.42 for frailty score 3 ( 352.60–4917.00 , P = 0.025 ) and & U20AC ; 419.53 for frailty score 4–6 ( −1909.00–2749.00 ) . Intervention was therefore significantly cost saving in moderately frail , but not in nonfrail or severely frail patients . Thus , DMP was dominant ( i.e. both less costly and more effective than usual care ) in moderately frail patients . At sensitivity analysis ,  DMP  remained dominant even to changes in cost of intervention and hospitalizations . Conclusion This suggests that an intensive , hospital-based DMP appears to be more effective in older patients with mild-to-moderate levels of frailty . Thus , a multidimensional assessment of frailty seems to be a useful tool for appropriate selection of model of care
The Frailty Index was examined in almost all these dimensions , with the exception of reliability , and its diagnostic and predictive characteristics were shown to be satisfactory .
Gait speed showed high sensitivity , but only moderate specificity , and excellent predictive ability for future disability in activities of daily living .
The Tilburg Frailty Indicator was shown to be a reliable and valid measure for frailty screening , but its diagnostic accuracy was not evaluated .
Screening Letter , Timed-up- and -go test and PRISMA 7 ( Preferred Reporting Items for Systematic Review s and Meta-Analyses ) demonstrated high sensitivity and moderate specificity for identifying frailty .
In general , low physical activity , variously measured , was one of the most powerful predictors of future decline in activities of daily living .
Conclusion Only a few frailty measures seem to be demonstrably valid , reliable and diagnostically accurate , and have good predictive ability .
Nevertheless , it was clear that no suitable tool for assessing frailty appropriately in emergency departments was identified
Background A scoping search identified systematic review s on diagnostic accuracy and predictive ability of frailty measures in older adults .
In most cases , research was confined to specific assessment measures related to a specific clinical model .
Objectives To summarize the best available evidence from systematic review s in relation to reliability , validity , diagnostic accuracy and predictive ability of frailty measures in older adults .