Article Figures & Tables
Tables
Tool Type Components examined Frailty scoring system Psychometric properties Time to complete, min Tool administered by Clinical Frailty Scale Judgment based Visual chart of nine pictures covering the frailty spectrum, with corresponding explanation text. Nine grades of frailty from 1 (very fit) to 9 (terminally ill). A score of 5 or more indicates frailty. Predictive validity and reliability36 < 5 Physicians or practice nurses Gait Speed Performance based Patient is asked to walk from one place to another at usual speed. Distance considered ranges from 2.4 to 6 m. A walking speed of < 0.8 m/s identifies patients at high risk of frailty. Diagnostic test accuracy34 < 5 Physicians or practice nurses Timed-up-and-go test Performance based The test measures the time taken to stand up from a chair, walk a distance of 3 m, turn, walk back and sit down. A time of > 10 s identifies patients at risk of frailty. Diagnostic test accuracy37 < 5 Physicians or practice nurses FRAIL Questionnaire Five items with yes/no answers: Fatigue
Resistance (ability to climb up one flight of stairs)
Ambulation (ability to walk one block)
Illness (> 5 comorbidities)
Loss of weight (> 5%)
Frailty: three or more components present Prefrailty: one to two components present Robust: zero components present Convergent and predictive validity38 < 5 Physicians, practice nurses, or patients or their family members Groningen Frailty Indicator Questionnaire Fifteen-item clinician-administered questionnaire concerning four domains: physical, social, psychological and cognitive. Frailty: scores > 4 Construct validity39 15 Physicians or practice nurses PRISMA-7 Questionnaire Seven-item self-completed questionnaire with yes or no answers that covers ADL limitations, age (> 85 yr) and sex Frailty: three or more components present Diagnostic test accuracy34 < 5 Self-administered Tilburg Frailty Indicator Questionnaire Contains two parts: 10 questions on determinants of frailty and diseases (Part A) and 15 questions on components of frailty in three domains (i.e., physical, psychologic and social frailty) (Part B) A score of 5 or more indicates frailty. Reliability, construct, predictive and concurrent types of validity40 < 15 Self-administered Frailty phenotype Mixed (questionnaire and performance based) Five items with yes or no answers: Weight loss over the past year (≥4.5 kg unintentionally)
Slow walking speed
Low grip strength
Exhaustion (two self-reported questions)
Low physical activity
Frailty: three or more components present Prefrailty: one or two components present Robust: no components present Concurrent and predictive validity10 15–20 Physicians or practice nurses SHARE Frailty Instrument (SHARE-FI) Mixed (questionnaire and performance based) Includes five variables: exhaustion, weight loss, weakness (as assessed by handgrip strength using a dynamometer), slowness and low activity Web-based calculator distinguishes three categories: nonfrail, prefrail and frail Construct and predictive validity41 < 10 Nonphysicians (e.g., nurses, allied health professionals) Study of Osteoporotic Fractures Mixed (Questionnaire and performance based) Three items with yes or no answers: Weight loss (> 5% intentional/unintentional)
Exhaustion (Do you feel full of energy?)
Inability to rise from a chair five times without using arms
Frailty: one or more components present
Prefrailty: one component present
Robust: No components presentPredictive validity42 < 5 Physicians or practice nurses Electronic Frailty Index Data set As per the Frailty Index below, with variables obtained from primary care electronic medical records Severe frailty: a score of > 0.36
Frailty: a score of 0.24–0.36
Mild frailty: a score of 0.12–0.24
Fit: a score of ≤ 0.12Predictive validity43 < 5 (if automated) Automatically computed from the electronic medical records* Frailty Index Data set Any 30 or more health deficits (variables) that increase in prevalence with age but do not plateau with age. Variables should be multidimensional, including ADLs/IADLs, comorbidities, mood, cognition and nutritional status. Frailty is measured on a continuum, although > 0.25 is often selected to define frailty.44 Criterion and construct validity45 20–30 Mostly administered by researchers; further use in clinical practice needs to be explored Edmonton Frail Scale Multidimensional Nine items: cognition, health (two items), admission to hospital, social support, nutrition, mood, function and continence Frailty: score > 7 Construct validity and reliability46 < 10 Physicians or practice nurses Note: ADL = activities of daily living, IADL = instrumental activities of daily living, PRISMA-7 = Program of Research to Integrate the Services for the Maintenance of Autonomy, SHARE = Survey of Health, Aging and Retirement in Europe.
↵* The Electronic Frailty Index is easy to use once it is automated in the electronic medical records; however, if done manually, it requires time and training.