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 .
Comparison of 2 frailty indexes for prediction of falls, disability, fractures, and death in older women.
BACKGROUND Frailty , as defined by the index derived from the Cardiovascular Health Study ( CHS index ) , predicts risk of adverse outcomes in older adults . Use of this index , however , is impractical in clinical practice . METHODS We conducted a prospect i ve cohort study in 6701 women 69 years or older to compare the predictive validity of a simple frailty index with the components of weight loss , inability to rise from a chair 5 times without using arms , and reduced energy level ( Study of Osteoporotic Fractures [ SOF index ] ) with that of the CHS index with the components of unintentional weight loss , poor grip strength , reduced energy level , slow walking speed , and low level of physical activity . Women were classified as robust , of intermediate status , or frail using each index . Falls were reported every 4 months for 1 year . Disability ( > or = 1 new impairment in performing instrumental activities of daily living ) was ascertained at 4(1/2 ) years , and fractures and deaths were ascertained during 9 years of follow-up . Area under the curve ( AUC ) statistics from receiver operating characteristic curve analysis and -2 log likelihood statistics were compared for models containing the CHS index vs the SOF index . RESULTS Increasing evidence of frailty as defined by either the CHS index or the SOF index was similarly associated with an increased risk of adverse outcomes . Frail women had a higher age-adjusted risk of recurrent falls ( odds ratio , 2.4 ) , disability ( odds ratio , 2.2 - 2.8 ) , nonspine fracture ( hazard ratio , 1.4 - 1.5 ) , hip fracture ( hazard ratio , 1.7 - 1.8 ) , and death ( hazard ratio , 2.4 - 2.7 ) ( P < .001 for all models ) . The AUC comparisons revealed no differences between models with the CHS index vs the SOF index in discriminating falls ( AUC = 0.61 for both models ; P = .66 ) , disability ( AUC = 0.64 ; P = .23 ) , nonspine fracture ( AUC = 0.55 ; P = .80 ) , hip fracture ( AUC = 0.63 ; P = .64 ) , or death ( AUC = 0.72 ; P = .10 ) . Results were similar when -2 log likelihood statistics were compared . CONCLUSION The simple SOF index predicts risk of falls , disability , fracture , and death as well as the more complex CHS index and may provide a useful definition of frailty to identify older women at risk of adverse health outcomes in clinical practice
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 .