PREDICTIVE ACCURACY OF FRAILTY MEASURES: OVERVIEW OF REVIEWS

Abstract

Frailty is an age-related state of high vulnerability to adverse health outcomes after a stressor event, predisposing individuals to progressive decline in different functional domains. A scoping search identified a large number of relevant systematic reviews (SRs) on predictive ability of frailty measures in older adults. Aiming to summarise this set of evidence an overview of reviews, based on the Joanna Briggs Institute (JBI) methodology, was conducted. This project "664367/FOCUS" was funded under the European Union's Health Programme (2014–2020). The studies considered as eligible for inclusion were quantitative SRs including older adults aged 60 years or more, recruited from any type of setting. Timeframe for searching was from January 2001 to October 2015. Of 420 records identified through searching in databases, 20 full-texts were assessed for inclusion criteria and 10 were included. Then 10 were assessed for risk of bias, using JBI critical appraisal checklist for systematic reviews and research synthesis. From those, three SRs conducted in community and emergency department settings and describing eight screening tools and eight frailty indicators were included. Between frailty measures applied to community dwelling older people, Frailty Index, gait speed and physical activity were shown to be the most powerful predictors of future adverse health outcomes. No suitable tool for assessing frailty appropriately in emergency departments was identified. Future research is required to investigate whether psychometric properties of available frailty measures are generalizable to health care settings other than primary care. There is a need for tools for use in emergency departments.