Instruments for the detection of frailty syndrome in older adults: A systematic review

Jossiana Wilke Faller; David do Nascimento Pereira; Suzana de Souza; Fernando Kenji Nampo; Fabiana de Souza Orlandi; Silvia Matumoto

doi:10.1371/journal.pone.0216166

Instruments for the detection of frailty syndrome in older adults: A systematic review

PLoS One. 2019 Apr 29;14(4):e0216166. doi: 10.1371/journal.pone.0216166. eCollection 2019.

Authors

Jossiana Wilke Faller¹, David do Nascimento Pereira², Suzana de Souza³, Fernando Kenji Nampo³, Fabiana de Souza Orlandi⁴, Silvia Matumoto¹

Affiliations

¹ Department of Maternal and Child Health and Public Health, University of São Paulo, PAHO/WHO Collaborating Center for Nursing Research Development, Ribeirão Preto School of Nursing, Ribeirão Preto, Brazil.
² Program in Health Promotion and Care in Hospital Care of the Medical School of the University of São Paulo, São Paulo, Brazil.
³ Latin-American Institute of Life and Natural Sciences, Federal University of Latin-American Integration, Foz do Iguassu, Paraná, Brazil.
⁴ Department of Gerontology of the Federal University of São Carlos, São Carlos, São Paulo, Brazil.

Abstract

Frailty is a dynamic process in which there is a reduction in the physical, psychological and/or social function associated with aging. The aim of this study was to identify instruments for the detection of frailty in older adults, characterizing their components, application scenarios, ability to identify pre-frailty and clinimetric properties evaluated. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), under registration number CRD42017039318. A total of 14 electronic sources were searched to identify studies that investigated instruments for the detection of frailty or that presented the construction and/or clinimetric evaluation of the instrument, according to criteria established by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). 96 studies were included in the qualitative synthesis: 51 instruments for the detection of frailty were identified, with predominantly physical domains; 40 were constructed and/or validated for use in the older adult community population, 28 only highlighted the distinction between frail and non-frail individuals and 23 presented three or more levels of frailty. The FRAGIRE, FRAIL Scale, Edmonton Frail Scale and IVCF-20 instruments were the most frequently analyzed in relation to clinimetric properties. It was concluded that: (I) there is a large number of instruments for measuring the same construct, which makes it difficult for researchers and clinicians to choose the most appropriate; (II) the FRAGIRE and CFAI stand out due to their multidimensional aspects, including an environmental assessment; however, (III) the need for standardization of the scales was identified, since the use of different instruments in clinical trials may prevent the comparability of the results in systematic reviews and; (IV) considering the different instruments identified in this review, the choice of researchers/clinicians should be guided by the issues related to the translation and validation for their location and the suitability for their context.

Publication types

Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Aged, 80 and over
Frail Elderly*
Frailty / diagnosis*
Frailty / mortality
Humans
Surveys and Questionnaires

Grants and funding

The authors thank the Coordination for the Improvement of Higher Education Personnel - Brazil (CAPES). JWF received support and funding from ITAIPU Binacional and the Araucária Foundation (FA), in addition to the PROEX grant: Aid N. 0524/2018, Case N. 23038.003643 / 2018-11. The funders had no additional role in the design of the study, data collection and analysis, decision to publish or preparation of the manuscript.