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Operationalization of Frailty Using Eight Commonly Used Scales and Comparison of Their Ability to Predict All‐Cause Mortality
Open accessAbstract
Objectives: To operationalize frailty using eight scales and to compare their content validity, feasibility, prevalence estimates of frailty, and ability to predict all‐cause mortality. Design: Secondary analysis of the Survey of Health, Ageing and Retirement in Europe ( SHARE ). Setting: Eleven European countries. Participants: Individuals aged 50 to 104 (mean age 65.3 ± 10.5, 54.8% female, N = 27,527). Measurements: Frailty was operationalized using SHARE data based on the Groningen Frailty Indicator, the Tilburg Frailty Indicator, a 70‐item Frailty Index ( FI ), a 44‐item FI based on a Comprehensive Geriatric Assessment ( FI ‐ CGA ), the Clinical Frailty Scale, frailty phenotype (weighted and unweighted versions), the Edmonton Frail Scale, and the FRAIL scale. Results: All scales had fewer than 6% of cases with at least one missing item, except the SHARE ‐frailty phenotype (11.1%) and the SHARE ‐Tilburg (12.2%). In the SHARE ‐Groningen, SHARE ‐Tilburg, SHARE ‐frailty phenotype, and SHARE ‐ FRAIL scales, death rates were 3 to 5 times as high in excluded cases as in included ones. Frailty prevalence estimates ranged from 6% ( SHARE ‐ FRAIL ) to 44% ( SHARE ‐Groningen). All scales categorized 2.4% of participants as frail. Of unweighted scales, the SHARE ‐ FI and SHARE ‐Edmonton scales most accurately predicted mortality at 2 ( SHARE ‐ FI area under the receiver operating characteristic curve ( AUC ) = 0.77, 95% confidence interval ( CI ) = 0.75–0.79); SHARE ‐Edmonton AUC = 0.76, 95% CI = 0.74–0.79) and 5 (both AUC = 0.75, 95% CI = 0.74–0.77) years. The continuous score of the weighted SHARE ‐frailty phenotype ( AUC = 0.77, 95% CI = 0.75–0.78) predicted 5‐year mortality better than the unweighted SHARE ‐frailty phenotype ( AUC = 0.70, 95% CI = 0.68–0.71), but the categorical score of the weighted SHARE ‐frailty phenotype did not ( AUC = 0.70, 95% CI = 0.68–0.72). Conclusion: Substantive differences exist between scales in their content validity, feasibility, and ability to predict all‐cause mortality. These frailty scales capture related but distinct groups. Weighting items in frailty scales can improve their predictive ability, but the trade‐off between specificity, predictive power, and generalizability requires additional evaluation.
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“Our cutpoints were as follows: Robust/Non-frail: 0.0 < 0.2; Pre-frail: 0.2 < 0.35; Frail: ≥ 0.35.”
From Frailty as determined by a comprehensive geriatric assessment-derived deficit-accumulation index in older patients with cancer who receive chemotherapy (2016) · cites this paper as [17]
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Cites
Frailty in Older Adults: Evidence for a Phenotype
Fried, L. P., Tangen, C. M., Walston, J., Newman, A. B., Hirsch, C., Gottdiener, J., Seeman, T., Tracy, R., Kop, W. J., Burke, G., et al. (2001) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/56.3.m146 · Cited by 24,907
A global clinical measure of fitness and frailty in elderly people
Rockwood, K. (2005) · Canadian Medical Association Journal · doi:10.1503/cmaj.050051 · Cited by 8,968
Self-citationA standard procedure for creating a frailty index
Searle, S. D., Mitnitski, A., Gahbauer, E. A., Gill, T. M., & Rockwood, K. (2008) · BMC Geriatrics · doi:10.1186/1471-2318-8-24 · Cited by 3,568
Self-citationPrevalence of frailty in community-dwelling older persons: a systematic review
Collard, R. M., Boter, H., Schoevers, R. A., & Oude Voshaar, R. C. (2012) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2012.04054.x · Cited by 3,073
Accumulation of Deficits as a Proxy Measure of Aging
Mitnitski, A. B., Mogilner, A. J., & Rockwood, K. (2001) · The Scientific World JOURNAL · doi:10.1100/tsw.2001.58 · Cited by 2,893 · cited 4×
“With how many of the following activities do you require help? (meal preparation, shopping, transportation, telephone, housekeeping, laundry, managing money, taking medications) 0–1 activities = 0; 2–4 activities = 1; 5–8 activities = 2 Please tell me if you have any difficulty with these because of a physical, mental…”
InfluentialSelf-citationFrailty as a predictor of surgical outcomes in older patients
Makary, M. A., Segev, D. L., Pronovost, P. J., Syin, D., Bandeen-Roche, K., Patel, P., Takenaga, R., Devgan, L., Holzmueller, C. G., Tian, J., et al. (2010) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2010.01.028 · Cited by 2,184
Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study
Hurria, A., Togawa, K., Mohile, S. G., Owusu, C., Klepin, H. D., Gross, C. P., Lichtman, S. M., Gajra, A., Bhatia, S., Katheria, V., et al. (2011) · Journal of Clinical Oncology · doi:10.1200/jco.2011.34.7625 · Cited by 1,841
Validity and reliability of the Edmonton Frail Scale
Rolfson, D. B., Majumdar, S. R., Tsuyuki, R. T., Tahir, A., & Rockwood, K. (2006) · Age and Ageing · doi:10.1093/ageing/afl041 · Cited by 1,643
Self-citationA comparison of two approaches to measuring frailty in elderly people
Rockwood, K., Andrew, M., & Mitnitski, A. (2007) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/62.7.738 · Cited by 1,291
Self-citationRodríguez‐Mañas, L., Féart, C., Mann, G. E., Viña, J., Chatterji, S., Chodzko-Zajko, W. J., Harmand, M. G., Bergman, H., Carcaillon‐Bentata, L., Nicholson, C., et al. (2012) · The Journals of Gerontology Series A · doi:10.1093/gerona/gls119 · Cited by 1,187
Self-citation
Research works printed but not linked: 4
- Börsch‐Supan A, 2005, The Survey of Health, Ageing and Retirement in Europe—Methodology
- Börsch‐Supan A, 2005, Health, ageing and retirement in Europe—First results from the Survey of Health, Ageing and Retirement in Europe
- World Health Organization Programme on Mental Health, 1996, WHOQOL‐BREF Introduction, Administration and Scoring
- Romero‐Ortuno R, 2011, The Frailty Instrument for primary care of the Survey of Health, Ageing and Retirement in Europe (SHARE‐FI): Results of the Spanish sample, Rev Esp Geriatr Gerontol, 46, 243
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Gilbert, T., Neuburger, J., Kraindler, J., Keeble, E., Smith, P., Ariti, C. A., Arora, S., Street, A., Parker, S. G., Roberts, H. C., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)30668-8 · Cited by 1,567
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Dent, E., Kowal, P. R., & Hoogendijk, E. O. (2016) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2016.03.007 · Cited by 1,356
Ambrosetti, M., Abreu, A., Corrà, U., Davos, C. H., Hansen, D., Frederix, I., Iliou, M. C., Pedretti, R. F. E., Schmid, J.-P., Vigorito, C., et al. (2021) · European Journal of Preventive Cardiology · doi:10.1177/2047487320913379 · Cited by 965
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Cesari, M., Prince, M. J., Thiyagarajan, J. A., de Carvalho, I. A., Bernabei, R., Chan, P., Gutiérrez‐Robledo, L. M., Michel, J., Morley, J. E., Ong, P., et al. (2016) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2015.12.016 · Cited by 774
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Gordon, E. H., Peel, N. M., Samanta, M., Theou, O., Howlett, S. E., & Hubbard, R. E. (2017) · Experimental Gerontology · doi:10.1016/j.exger.2016.12.021 · Cited by 686
“The characteristics of the FI and its ability to predict all-cause mortality have been confirmed by multiple studies of older cohorts from different cultural backgrounds (Garcia-Gonzalez et al., 2009; Goggins et al., 2005; Mitnitski et al., 2001, 2004; Theou et al., 2013).”
Self-citationMeasuring Frailty in Medicare Data: Development and Validation of a Claims-Based Frailty Index
Kim, D. H., Schneeweiß, S., Glynn, R. J., Lipsitz, L. A., Rockwood, K. J., & Avorn, J. (2017) · The Journals of Gerontology Series A · doi:10.1093/gerona/glx229 · Cited by 628
Self-citationFrailty and cancer: Implications for oncology surgery, medical oncology, and radiation oncology
Ethun, C. G., Bilen, M. A., Jani, A. B., Maithel, S. K., Ogan, K., & Master, V. A. (2017) · CA A Cancer Journal for Clinicians · doi:10.3322/caac.21406 · Cited by 590
Burden of frailty in the elderly population: perspectives for a public health challenge
Buckinx, F., Rolland, Y., Reginster, J., Ricour, C., Pétermans, J., & Bruyère, O. (2015) · Archives of Public Health · doi:10.1186/s13690-015-0068-x · Cited by 497
“This model consider frailty as a multidimensional risk state that can be measured more by the quantity than by the nature of health problems [24].”
Cesari, M., Calvani, R., & Marzetti, E. (2017) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2017.02.002 · Cited by 459
Frailty in NHANES: Comparing the frailty index and phenotype
Blodgett, J. M., Theou, O., Kirkland, S., Andreou, P., & Rockwood, K. J. (2015) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2015.01.016 · Cited by 454
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BackgroundMethodResultInfluentialSelf-citationAn overview of co-morbidities and the development of pressure ulcers among older adults
Jaul, E., Barron, J. S., Rosenzweig, J. P., & MENCZEL, J. (2018) · BMC Geriatrics · doi:10.1186/s12877-018-0997-7 · Cited by 375
Biomarkers shared by frailty and sarcopenia in older adults: A systematic review and meta-analysis
Picca, A., Coelho‐Júnior, H. J., Calvani, R., Marzetti, E., & Vetrano, D. L. (2021) · Ageing Research Reviews · doi:10.1016/j.arr.2021.101530 · Cited by 383
Association between oral health and frailty: A systematic review of longitudinal studies
Hakeem, F. F., Bernabé, E., & Sabbah, W. (2019) · Gerodontology · doi:10.1111/ger.12406 · Cited by 344
McIsaac, D. I., Bryson, G. L., & van Walraven, C. (2016) · JAMA Surgery · doi:10.1001/jamasurg.2015.5085 · Cited by 332
What do we know about frailty in the acute care setting? A scoping review
Theou, O., Squires, E., Mallery, K., Lee, J. S., Fay, S., Goldstein, J., Armstrong, J. J., & Rockwood, K. J. (2018) · BMC Geriatrics · doi:10.1186/s12877-018-0823-2 · Cited by 313
“Among community-dwelling people over the age of 50 years approximately 20% are frail [2, 3].”
BackgroundSelf-citationFrailty for Perioperative Clinicians: A Narrative Review
McIsaac, D. I., Macdonald, D. B., & Aucoin, S. D. (2020) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000004602 · Cited by 317
Maguet, P. L., Roquilly, A., Lasocki, S., Asehnoune, K., Carise, E., Martin, M. S., Mimoz, O., Gac, G. L., Somme, D., Cattenoz, C., et al. (2014) · Intensive Care Medicine · doi:10.1007/s00134-014-3253-4 · Cited by 298
Frailty, Sarcopenia and Diabetes
Morley, J. E., Malmstrom, T. K., Rodriguez-Mañas, L., & Sinclair, A. J. (2014) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2014.10.001 · Cited by 277
Agreement Between 35 Published Frailty Scores in the General Population
Aguayo, G., Donneau, A., Vaillant, M., Schritz, A., Franco, O. H., Stranges, S., Malisoux, L., Guillaume, M., & Witte, D. R. (2017) · American Journal of Epidemiology · doi:10.1093/aje/kwx061 · Cited by 273
“The authors concluded that FS have significant differences regarding validity, feasibility, and predictive ability (12).”
BackgroundMethodInfluentialFrailty and Comprehensive Geriatric Assessment
Lee, H., Lee, E., & Jang, I. (2019) · Journal of Korean Medical Science · doi:10.3346/jkms.2020.35.e16 · Cited by 279
Hoogendijk, E. O., van Hout, H. P. J., Heymans, M. W., van der Horst, H. E., Frijters, D. H. M., Groenou, M. I. B. V., Deeg, D. J. H., & Huisman, M. A. (2014) · Annals of Epidemiology · doi:10.1016/j.annepidem.2014.05.002 · Cited by 233
Álvarez-Nebreda, M. L., Bentov, N., Urman, R. D., Setia, S., Huang, J. C.-S., Pfeifer, K. J., Bennett, K. A., Ong, T. D., Richman, D. C., Gollapudi, D., et al. (2018) · Journal of Clinical Anesthesia · doi:10.1016/j.jclinane.2018.02.011 · Cited by 234
“For instance, the prevalence of frailty in a sample of elderly patients living in the community will be lower using the FRAIL scale than what is found using the Edmonton score [11].”
Herr, M., Robine, J., Pinot, J., Arvieu, J., & Ankri, J. (2015) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.3772 · Cited by 216
Jayanama, K., Theou, O., Godin, J., Mayo, A., Cahill, L. E., & Rockwood, K. J. (2022) · BMC Medicine · doi:10.1186/s12916-022-02596-7 · Cited by 216
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MethodSelf-citationIdentifying Common Characteristics of Frailty Across Seven Scales
Theou, O., Brothers, T. D., Peña, F. G., Mitnitski, A., & Rockwood, K. (2014) · Journal of the American Geriatrics Society · doi:10.1111/jgs.12773 · Cited by 209
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BackgroundMethodResultInfluentialSelf-citationCohen, H. J., Smith, D., Sun, C., Tew, W., Mohile, S. G., Owusu, C., Klepin, H. D., Gross, C. P., Lichtman, S. M., Gajra, A., et al. (2016) · Cancer · doi:10.1002/cncr.30269 · Cited by 203
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BackgroundBlodgett, J. M., Theou, O., Howlett, S. E., & Rockwood, K. J. (2017) · GeroScience · doi:10.1007/s11357-017-9993-7 · Cited by 203
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Frailty in an Older Inpatient Population
Basic, D., & Shanley, C. (2014) · Journal of Aging and Health · doi:10.1177/0898264314558202 · Cited by 203
Age-related deficit accumulation and the diseases of ageing
Rockwood, K., & Howlett, S. E. (2019) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2019.04.005 · Cited by 198
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Theou, O., Haviva, C., Wallace, L. M. K., Searle, S. D., & Rockwood, K. J. (2023) · Age and Ageing · doi:10.1093/ageing/afad221 · Cited by 196
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Vigorito, C., Abreu, A., Ambrosetti, M., Belardinelli, R., Corrà, U., Cupples, M., Davos, C. H., Hoefer, S., Iliou, M., Schmid, J., et al. (2016) · European Journal of Preventive Cardiology · doi:10.1177/2047487316682579 · Cited by 200
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Pajewski, N. M., Williamson, J. D., Applegate, W. B., Berlowitz, D. R., Bolin, L. P., Chertow, G. M., Krousel-Wood, M. A., Barrera, N. L., Powell, J. R., Roumie, C. L., et al. (2016) · The Journals of Gerontology Series A · doi:10.1093/gerona/glv228 · Cited by 187
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BackgroundMcIsaac, D. I., Moloo, H., Bryson, G. L., & van Walraven, C. (2017) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000001960 · Cited by 178
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Morley, J. E., von Haehling, S., Anker, S. D., & Vellas, B. J. (2014) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1007/s13539-014-0132-3 · Cited by 173
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MethodGuaraldi, G., Brothers, T. D., Zona, S., Stentarelli, C., Carli, F., Malagoli, A., Santoro, A., Menozzi, M., Mussi, C., Mussini, C., et al. (2015) · AIDS · doi:10.1097/qad.0000000000000753 · Cited by 171
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BackgroundMethodSelf-citationButt, J. H., Jhund, P. S., Bělohlávek, J., de Boer, R. A., Chiang, C., Desai, A. S., Dróżdż, J., Hernandez, A. F., Inzucchi, S. E., Katova, T., et al. (2022) · Circulation · doi:10.1161/circulationaha.122.061754 · Cited by 179
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Biasio, J. C. D., Mittel, A. M., Mueller, A., Ferrante, L. E., Kim, D. H., & Shaefi, S. (2020) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000004665 · Cited by 173
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Gracie, T. J., Caufield-Noll, C. P., Wang, N., & Sieber, F. E. (2021) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000005609 · Cited by 165
Park, C., & Ko, F. (2021) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2021.05.008 · Cited by 181
Butt, J. H., Dewan, P., Merkely, B. P., Bělohlávek, J., Dróżdż, J., Kitakaze, M., Inzucchi, S. E., Kosiborod, M., Martínez, F. A., Tereshchenko, S. N., et al. (2022) · Annals of Internal Medicine · doi:10.7326/m21-4776 · Cited by 163
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Erlandson, K. M., Schrack, J. A., Jankowski, C. M., Brown, T. T., & Campbell, T. (2014) · Current HIV/AIDS Reports · doi:10.1007/s11904-014-0215-y · Cited by 166
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Kojima, G. (2018) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2018.04.006 · Cited by 160
Bu, Z., Huang, A., Xue, M., Li, Q. Y., Bai, Y., & Xu, G. (2020) · Brain and Behavior · doi:10.1002/brb3.1926 · Cited by 174
“Multiple system assessment (Kojima et al., 2018; Malmstrom et al., 2014; Theou et al., 2013) also confirms that the prediction effectiveness of FI on disability, mortality, and other adverse outcomes is better than that of other assessment instruments, which is consistent with the results of the…”
Result(2013) · European Journal of Ageing · doi:10.1007/10433.1613-9380 · Cited by 158
Pritchard, J. M., Kennedy, C. C., Karampatos, S., Ioannidis, G., Misiaszek, B., Marr, S., Patterson, C., Woo, T., & Παπαϊωάννου, Α. (2017) · BMC Geriatrics · doi:10.1186/s12877-017-0623-0 · Cited by 154
Prevalence of frailty in Canadians 18–79 years old in the Canadian Health Measures Survey
Kehler, D. S., Ferguson, T. W., Stammers, A. N., Bohm, C. J., Arora, R. C., Duhamel, T. A., & Tangri, N. (2017) · BMC Geriatrics · doi:10.1186/s12877-017-0423-6 · Cited by 150
“However, previous studies show that a modified Fried criteria is associated with adverse events [26, 27, 36].”
BackgroundMethodResultHao, Q., Zhou, L., Dong, B., Yang, M. J., Dong, B., & Weil, Y. (2019) · Scientific Reports · doi:10.1038/s41598-018-38072-7 · Cited by 150
Kim, D. H., & Schneeweiß, S. (2014) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.3674 · Cited by 140
Frailty in People Aging With Human Immunodeficiency Virus (HIV) Infection
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Self-citationThe implication of frailty on preoperative risk assessment
Amrock, L. G., & Deiner, S. G. (2014) · Current Opinion in Anaesthesiology · doi:10.1097/aco.0000000000000065 · Cited by 139
Peng, Y., Zhong, G., Zhou, X., Guan, L., & Zhou, L. (2022) · BMC Geriatrics · doi:10.1186/s12877-022-03404-w · Cited by 144
“However, some comparative studies [7, 91] have also found substantive differences between these tools in their validity, feasibility, and ability to predict mortality.”
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Runner, R. P., Bellamy, J. L., Vu, C. C. L., Erens, G. A., Schenker, M. L., & Guild, G. N. (2017) · The Journal of Arthroplasty · doi:10.1016/j.arth.2017.03.046 · Cited by 135
Marcucci, M., Damanti, S., Germini, F., Apóstolo, J., Campos, E. B., Gwyther, H., Holland, C., Kurpas, D., Bujnowska–Fedak, M. M., Szwamel, K., et al. (2019) · BMC Medicine · doi:10.1186/s12916-019-1434-2 · Cited by 133
Oviedo-Briones, M., Rodríguez‐Laso, Á., Carnicero, J. A. C., Cesari, M., Grodzicki, T. K., Gryglewska, B., Sinclair, A. J., Landi, F., Vellas, B. J., Checa‐López, M., et al. (2020) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2020.09.024 · Cited by 145
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Cooper, Z. R., Rogers, S. O., Ngo, L. H., Guess, J. R., Schmitt, E. M., Jones, R. N., Ayres, D. K., Walston, J. D., Gill, T. M., Gleason, L. J., et al. (2016) · Journal of the American Geriatrics Society · doi:10.1111/jgs.14387 · Cited by 131
“Nonetheless, FP and FI are generally considered the most-studied and -robust measures based on the available evidence because they have been found to have strong predictive value in other studies.(45) Although a large prospective cohort of individuals undergoing orthopedic procedures was examined, the generalizability…”
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“Other frailty measures can also be considered as special cases of the FI (Theou et al. 2013a) and often are specialized.”
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Rockwood, K. J. (2016) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2016.03.020 · Cited by 118
Self-citationHow should older adults with cancer be evaluated for frailty?
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McIsaac, D. I., Wong, C. A., Huang, A. R., Moloo, H., & van Walraven, C. (2018) · Annals of Surgery · doi:10.1097/sla.0000000000002769 · Cited by 119
“Typically, there is moderate agreement between different frailty instruments, however, each tends to identify a distinct, but related, group of patients.(55,56) While reasons exist for heterogeneity in selection of frailty instruments,(11) advancing the science of perioperative frailty in a manner than can meaningfull…”
BackgroundPeball, M., Mahlknecht, P., Werkmann, M., Marini, K., Murr, F., Herzmann, H., Stockner, H., Marzi, R. D., Heim, B., Djamshidian, A., et al. (2018) · Gerontology · doi:10.1159/000492572 · Cited by 120
Amblàs-Novellas, J., Martori, J. C., Molist‐Brunet, N., Oller, R., Gómez‐Batiste, X., & Panicot, J. E. (2016) · Revista Española de Geriatría y Gerontología · doi:10.1016/j.regg.2016.09.003 · Cited by 133
“0% Vivos (n) % (1) 100 (7) 100 (14) 100 (25) 100 (21) 100 (26) 96,3 (27) 93,1 (27) 84,4 (26) 76,5 (42) 76,4 (45) 62,5 (26) 43,3 (24) 38,1 (5) 11,6 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (n) (0) (0) (0) (0) (0) (1) (2) (5) 6 (8) 23,5 (13) (27) (34) (39) (38) (45) (32) (26) (3) (1) Exitus”
Interventions to Mobilize Elderly Patients and Reduce Length of Hospital Stay
Surkan, M., & Gibson, W. (2018) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2018.04.033 · Cited by 118
Assessing the social dimension of frailty in old age: A systematic review
Bessa, B., Ribeiro, Ó. M., & Coelho, T. (2018) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2018.06.005 · Cited by 122
Is It Time to Begin a Public Campaign Concerning Frailty and Pre-frailty? A Review Article
Sacha, J., Sacha, M., Soboń, J., Borysiuk, Z., & Feusette, P. (2017) · Frontiers in Physiology · doi:10.3389/fphys.2017.00484 · Cited by 117
“Studies comparing uni- and multidimensional measures of frailty have demonstrated large differences in their ability to identify frail older adults (Hoogendijk et al., 2013; Theou et al., 2013; Jung et al., 2014; Roppolo et al., 2015).”
BackgroundScreening for frailty in Canada’s health care system: A time for action
Muscedere, J., Andrew, M. K., Bagshaw, S. M., Estabrooks, C., Hogan, D., Holroyd-Leduc, J., Howlett, S., Lahey, W., Maxwell, C., McNally, M., et al. (2016) · Canadian Journal on Aging / La Revue canadienne du vieillissement · doi:10.1017/s0714980816000301 · Cited by 112
Socioeconomic inequalities in frailty and frailty components among community-dwelling older citizens
Franse, C. B., van Grieken, A., Li, Q., Melis, R. J. F., Rietjens, J. A. C., & Raat, H. (2017) · PLoS ONE · doi:10.1371/journal.pone.0187946 · Cited by 108
“In the FI approach and other frailty measures such as the FRAIL scale, morbidities are considered as part of frailty [2, 12].”
BackgroundAssociation of vitamin D deficiency and frailty: A systematic review and meta-analysis.
Zhou, J.-H., Huang, P., Liu, P., Hao, Q., Chen, S.-P., Dong, B., & Wang, J. (2016) · Maturitas · doi:10.1016/j.maturitas.2016.09.003 · Cited by 95
A systematic review of the association between sedentary behaviors with frailty
Kehler, D. S., Hay, J. L., Stammers, A. N., Hamm, N. C., Kimber, D. E., Schultz, A. S. H., Szwajcer, A., Arora, R. C., Tangri, N., & Duhamel, T. A. (2018) · Experimental Gerontology · doi:10.1016/j.exger.2018.10.010 · Cited by 104
Development and validation of a frailty index in the Longitudinal Aging Study Amsterdam
Hoogendijk, E. O., Theou, O., Rockwood, K. J., Onwuteaka-Philipsen, B. D., Deeg, D. J. H., & Huisman, M. A. (2016) · Aging Clinical and Experimental Research · doi:10.1007/s40520-016-0689-0 · Cited by 104
Self-citationFrail-VIG index: a concise frailty evaluation tool for rapid geriatric assessment
Amblàs-Novellas, J., Martori, J. C., Espaulella, J., Oller, R., Molist‐Brunet, N., Inzitari, M., & Romero‐Ortuño, R. (2018) · BMC Geriatrics · doi:10.1186/s12877-018-0718-2 · Cited by 109
“Other requirements for the Frail-VIG index was that it meet or exceed the characteristics of existing FIs [4, 16] in terms of the submaximal limit for the FI score (99% of individuals with an FI < 0.”
BackgroundMethodResultInfluentialValentini, A., Federici, M., Cianfarani, M. A., Tarantino, U., & Bertoli, A. (2018) · Clinical Interventions in Aging · doi:10.2147/cia.s164174 · Cited by 103
Eckart, A., Hauser, S. I., Haubitz, S., Struja, T., Kutz, A., Koch, D., Neeser, O. L., Meier, M. A., Müeller, B., & Schüetz, P. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-026923 · Cited by 106
Exploring the efficiency of the Tilburg Frailty Indicator: a review
Gobbens, R. J. J., Schols, J. M. G. A., & van Assen, M. A. L. M. (2017) · Clinical Interventions in Aging · doi:10.2147/cia.s130686 · Cited by 112
“93,94 However, the predictive power of the individual frailty components will depend strongly on the adverse outcome that will be examined.”
Operationalizing Frailty Using the Frailty Phenotype and Deficit Accumulation Approaches
Theou, O., Walston, J. D., & Rockwood, K. J. (2015) · Interdisciplinary topics in gerontology and geriatrics · doi:10.1159/000381164 · Cited by 101
“When eight frailty scales were recently applied to a representative sample of middle-aged and older Europeans in the Survey of Health, Ageing, and Retirement in Europe (SHARE), they all identified frailty and predicted all-cause mortality, even though they captured related but distinct components and varied in the acc…”
MethodSelf-citationFrailty: Identifying elderly patients at high risk of poor outcomes.
Lee, L. S., Heckman, G. A., & Molnar, F. (2015) · PubMed Central · Cited by 98
Falk, H., Guðnadóttir, G. S., Alfredsson, J., Cederholm, T., Ekerstad, N., Religa, D., Nellgård, B., & Wilhelmson, K. (2023) · Clinical Interventions in Aging · doi:10.2147/cia.s388160 · Cited by 110
“7,8,12 Although one primary purpose of the CFS is risk stratification, it may also be used as a screening tool to identify frail patients needing further geriatric evaluation, i.e. comprehensive geriatric assessment (CGA).”
Frailty-aware care: giving value to frailty assessment across different healthcare settings
Boreskie, K. F., Hay, J. L., Boreskie, P. E., Arora, R. C., & Duhamel, T. A. (2022) · BMC Geriatrics · doi:10.1186/s12877-021-02722-9 · Cited by 105
“This tool has also been associated with adverse outcomes such as mortality [65].”
BackgroundUnifying aging and frailty through complex dynamical networks
Rutenberg, A. D., Mitnitski, A., Farrell, S. G., & Rockwood, K. J. (2017) · Experimental Gerontology · doi:10.1016/j.exger.2017.08.027 · Cited by 97
Self-citationAdherence to Mediterranean Diet and Frailty
Ntanasi, E., Yannakoulia, M., Kosmidis, M.-H., Anastasiou, C. A., Dardiotis, E., Hadjigeorgiou, G., Sakka, P., & Scarmeas, N. (2018) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2017.11.005 · Cited by 94
Association of Frailty and Long‐Term Survival in Patients Undergoing Coronary Artery Bypass Grafting
Tran, D. T. T., Tu, J. V., Dupuis, J., Eddeen, A. B., & Sun, L. Y. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.118.009882 · Cited by 97
“To date, several frailty scales exist to capture related, but distinct, groups that form different dimensions of frailty.(31) A direct comparison of 8 commonly used frailty instruments demonstrated limited agreement between these instruments.”
BackgroundOlder Adults in the Emergency Department with Frailty
Theou, O., Campbell, S., Malone, M. L., & Rockwood, K. J. (2018) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2018.04.003 · Cited by 98
Self-citationEvaluation of Clinically Meaningful Changes in Measures of Frailty
Jang, I., Jung, H., Lee, H., Park, H., Lee, E., & Kim, D. H. (2020) · The Journals of Gerontology Series A · doi:10.1093/gerona/glaa003 · Cited by 95
Frailty and Outcomes After Myocardial Infarction: Insights From the CONCORDANCE Registry
Patel, A., Goodman, S. G., Yan, A. T.-K., Alexander, K. P., Wong, C. L., Cheema, A. N., Udell, J. A., Kaul, P., D'Souza, M. I., Hyun, K. K., et al. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.118.009859 · Cited by 92
“consider >5 deficits.(16) Dodson et al demonstrated that gait speed, a component of the frailty phenotype, measured 1 month after MI was associated with a 2-fold increase in mortality at 1 year, but its significance independent of clinical factors was unclear.”
BackgroundStow, D., Spiers, G., Matthews, F. E., & Hanratty, B. (2019) · Palliative Medicine · doi:10.1177/0269216319828650 · Cited by 99
Common Ground? The Concordance of Sarcopenia and Frailty Definitions
Reijnierse, E. M., Trappenburg, M. C., Blauw, G. J., Verlaan, S., de van der Schueren, M. A. E., Meskers, C. G. M., & Maier, A. B. (2016) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2016.01.013 · Cited by 98
Hoogendijk, E. O., Rockwood, K. J., Theou, O., Armstrong, J. J., Onwuteaka-Philipsen, B. D., Deeg, D. J. H., & Huisman, M. A. (2018) · Age and Ageing · doi:10.1093/ageing/afy081 · Cited by 91
Self-citationModified Frailty Index Is an Effective Risk Assessment Tool in Primary Total Hip Arthroplasty
Bellamy, J. L., Runner, R. P., Vu, C. C. L., Schenker, M. L., Bradbury, T. L., & Roberson, J. R. (2017) · The Journal of Arthroplasty · doi:10.1016/j.arth.2017.04.056 · Cited by 90
Mulasso, A., Roppolo, M., Gobbens, R. J. J., Mosso, C. O., & Rabaglietti, E. (2015) · Clinical Interventions in Aging · doi:10.2147/cia.s92328 · Cited by 89
Amrock, L. G., Neuman, M. D., Lin, H., & Deiner, S. G. (2014) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2014.04.018 · Cited by 89
Theou, O., van der Valk, A. M., Godin, J., Andrew, M. K., McElhaney, J. E., McNeil, S., & Rockwood, K. J. (2020) · The Journals of Gerontology Series A · doi:10.1093/gerona/glaa084 · Cited by 87
Self-citationMotta, F., Sica, A., & Selmi, C. F. (2020) · Frontiers in Immunology · doi:10.3389/fimmu.2020.576134 · Cited by 92
“The FI-CD has a high predictive value for adverse clinical outcomes (35) and it seems that its total score, rather than type of health deficit, may better predict adverse outcomes (36).”
BackgroundThe Impact of Functional Dependency on Outcomes After Complex General and Vascular Surgery
Scarborough, J. E., Bennett, K. M., Englum, B. R., Pappas, T. N., & Lagoo‐Deenadayalan, S. A. (2014) · Annals of Surgery · doi:10.1097/sla.0000000000000767 · Cited by 91
Shaw, B. H., Borrel, D., Sabbaghan, K., Kum, C., Yang, Y., Robinovitch, S. N., & Claydon, V. E. (2019) · BMC Geriatrics · doi:10.1186/s12877-019-1082-6 · Cited by 83
Brousseau, A.-A., Dent, E., Hubbard, R. E., Melady, D., Émond, M., Mercier, É., Costa, A. P., Gray, L., Hirdes, J. P., Dey, A. B., et al. (2017) · Age and Ageing · doi:10.1093/ageing/afx168 · Cited by 82
“We confirmed that the FI-ED had similar properties to more detailed frailty indices that were validated and are in use in other contexts [28, 29], and we established that the FI-ED was associated with a variety of patient-centred and system-centred outcomes.”
ResultZazzara, M. B., Vetrano, D. L., Carfì, A., & Onder, G. (2020) · Panminerva Medica · doi:10.23736/s0031-0808.19.03731-5 · Cited by 81
Romero‐Ortuño, R., & Soraghan, C. J. (2014) · BMJ Open · doi:10.1136/bmjopen-2014-006645 · Cited by 87
Frailty and Cognitive Impairment in Predicting Mortality Among Oldest-Old People
Hao, Q., Dong, B., Yang, M. J., Dong, B., & Wei, Y. (2018) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2018.00295 · Cited by 80
“Furthermore, FI could be used to classify more people as frail, as it is based on a more comprehensive geriatric assessment, such as physical examinations, multi-functional measures, and diagnostic data, and hence, more capable of predicting mortality than frailty phenotype measurements (Theou et al., 2013; Cesari et…”
Background
Metadata
- Authors
- Theou, O., Brothers, T. D., Mitnitski, A., & Rockwood, K.
- Affiliations
- Dalhousie University (CA)
- Corresponding author
- Rockwood, Kenneth
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2013-08-26
- Volume
- 61
- Issue
- 9
- Pages
- 1537-1551
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- OpenAlex
- W2037844081
- Cited by
- 665
- References
- 49
- Citations by year
- 2026: 30 · 2025: 42 · 2024: 51 · 2023: 55 · 2022: 76 · 2021: 63 · 2020: 62 · 2019: 59 · 2018: 47 · 2017: 63 · 2016: 58 · 2015: 32 · 2014: 24 · 2013: 3
- FWCI
- 18.14
- Type
- journal article
- Language
- en
- Open access
- green
- zenodo.org
- Licence
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Zenodo (CERN European Organization for Nuclear Research) (submittedVersion, other-oa)
- Funders
- European Commission through the Fifth Framework Programme (QLK6-CT-2001-00360)
- U.S. National Institute (U01 AG09740-13S2, P01 AG005842, P01 AG08291, P30 AG12815, R21 AG025169, Y1-AG-4553-01, IAG BSR06-11, OGHA 04-064)
- German Ministry of Education and Research
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- frailty, frailty assessment tools, all-cause mortality prediction, frailty index, Clinical Frailty Scale, Fried frailty phenotype, Edmonton Frail Scale, FRAIL scale, Tilburg Frailty Indicator, Groningen Frailty Indicator, comprehensive geriatric assessment, frailty prevalence, SHARE survey, older adults, mortality risk stratification, content validity
- MeSH terms
- Aged, Aged, 80 and over, Cause of Death, Europe, Female, Health Surveys, Humans, Male, Middle Aged, Reproducibility of Results, Geriatric Assessment, Survival Rate, Frail Elderly
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