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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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InfluentialSelf-citationFrailty as a predictor of surgical outcomes in older patients
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The Silent Epidemic - Frailty and Aging with HIV.
Willig, A. L., Overton, E. T., & Saag, M. S. (2016) · PubMed · Cited by 22
Unifying ageing and frailty through complex dynamical networksPreprint
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Self-citationFinerenone According to Frailty in Heart Failure
Butt, J. H., Jhund, P. S., Henderson, A. D., Claggett, B. L., Chiang, C., Linssen, G. C. M., Saldarriaga, C., Saraiva, J. F. K., Sato, N., Schou, M., et al. (2025) · JAMA Cardiology · doi:10.1001/jamacardio.2025.1775 · Cited by 27
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“However, most of these have been deployed in single-institution datasets and there is increased interest in studying frailty utilizing large, national databases.(19,20) One metric of frailty designed specifically for use in these datasets is the hospital frailty risk score (HFRS), which is calculated using 109 interna…”
Stoicea, N., Baddigam, R., Wajahn, J., Sipes, A., Arias-Morales, C. E., Gastaldo, N., & Bergese, S. D. (2016) · Frontiers in Public Health · doi:10.3389/fpubh.2016.00150 · Cited by 20
“recommend the use of the SHARE-EFS because it was shown to have the best predictive ability of all-cause mortality (29).”
BackgroundMethodInfluentialZhang, H.-T., Tan, N., Gao, Y., She, K., Luo, Q., Yao, K.-R., Tang, X., Li, L., Zhao, L., Wang, Z.-H., et al. (2024) · Geriatric Nursing · doi:10.1016/j.gerinurse.2024.08.013 · Cited by 19
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Qin, F., Guo, Y., Ruan, Y., Huang, Z., Sun, S., Gao, S., Ye, J., & Wu, F. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1154809 · Cited by 21
“The results are consistent with those of other studies (10, 11, 18), althoughmost of them focus on mortality.”
MethodResultGustafson, D., Shi, Q., Holman, S., MINKOFF, H. L., Cohen, M. H., Plankey, M. W., Havlik, R. J., Sharma, A., Gange, S. J., Gandhi, M., et al. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-013993 · Cited by 19
Socioeconomic Position, Multimorbidity and Mortality in a Population Cohort: The HUNT Study
Vinjerui, K. H., Bjørngaard, J. H., Krokstad, S., Douglas, K. A., & Sund, E. R. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9092759 · Cited by 19
“While various frailty measures identify distinct subgroups, all are associated with mortality [22].”
BackgroundRao, S., Wallace, L. M. K., Theou, O., & Rockwood, K. J. (2016) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4559 · Cited by 20
“To assess risk of frailty in predictive models and facilitate comparison with mortality participants with a frailty index value of 0–0.24 were considered “non-frail”, and those with a value of ≥0.25 were deemed “frail” (Theou et al., 2013).”
BackgroundInfluentialSelf-citationStreet, A., Maynou, L., Blodgett, J. M., & Conroy, S. (2025) · The Lancet Healthy Longevity · doi:10.1016/j.lanhl.2025.100740 · Cited by 18
Nutritional Supplementation and Sarcopenia: The Evidence Grows
Morley, J. E. (2015) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2015.06.001 · Cited by 18
Association between Dysphagia and Surgical Outcomes across the Continuum of Frailty
Cohen, S. M., Starr, K. N. P., Risoli, T. J., Lee, H., Misono, S., Jones, H. N., & Raman, S. R. (2021) · Journal of Nutrition in Gerontology and Geriatrics · doi:10.1080/21551197.2021.1929644 · Cited by 18
Liu, C., Gong, N., & Liu, W. (2021) · Journal of PeriAnesthesia Nursing · doi:10.1016/j.jopan.2020.12.006 · Cited by 18
Kang, M., Baek, J. Y., Jo, Y., Ryu, D., Jang, I., Jung, H., & Kim, B. (2024) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.13561 · Cited by 18
“9,10 In fact, a recent longitudinal study has underscored the frailty index as the most reliable indicator of biological age, 11 promoting its use as a primary endpoint in clinical research on aging.”
BackgroundCherubini, A., Demougeot, L., Cruz-Jentoft, A. J., Çurgunlu, A., Michel, J., Roberts, H. C., Sayer, A. A., Strandberg, T. E., Topinková, E., Trotta, F. M., et al. (2015) · European Geriatric Medicine · doi:10.1016/j.eurger.2015.09.003 · Cited by 19
“Moreover, it has been demonstrated in literature that the agreement across frailty instrument tends to be quite modest [30,31].”
BackgroundSantiago, L. M., Gobbens, R. J. J., Mattos, I. E., & Ferreira, D. B. (2018) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2018.12.003 · Cited by 18
Frailty Index is Associated with Adverse Outcomes after Aortic Valve Replacement in Elderly Patients
Sohn, B., Choi, J. W., Hwang, H. Y., Jang, M., Kim, K. H., & Kim, K. (2019) · Journal of Korean Medical Science · doi:10.3346/jkms.2019.34.e205 · Cited by 18
Rangasamy, V., Henriques, T. S., Xu, X., & Subramaniam, B. (2019) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2019.09.035 · Cited by 18
Association of blood biomarkers with frailty–A mapping review
Fritzenschaft, L., Boehm, F., Rothenbacher, D., Denkinger, M. D., & Dallmeier, D. (2025) · Ageing Research Reviews · doi:10.1016/j.arr.2025.102761 · Cited by 17
“While all these instruments are well validated and show high predictive abilities of adverse clinical outcomes (Bandeen-Roche et al., 2006; Fried et al., 2001; Lee et al., 2015; Theou et al., 2013), their applicability in certain clinical situations may be limited on multiple levels.”
Rogers, N. T., Blodgett, J. M., Searle, S. D., Cooper, R., Davis, D. H. J., & Pereira, S. M. P. (2021) · American Journal of Epidemiology · doi:10.1093/aje/kwab038 · Cited by 17
“While there is no universal consensus regarding the operationalization of frailty (3), the 2 most common approaches define frailty as a phenotype (4) (based on 5 predefined physical frailty criteria (5)) or a frailty index (FI), based on an accumulation of health-related deficits (6, 7).”
BackgroundTransitions in Frailty and 4-Year Mortality Risk in Taiwan Longitudinal Study on Aging
Hwang, A., Chen, L., Tang, T.-C., Peng, L.-N., Lin, M., Chou, Y., Hsiao, F., & Chen, L. (2022) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2022.10.005 · Cited by 17
Inflammatory markers and frailty in home-dwelling elderly, a cross-sectional study
Bålsrud, P., Ulven, S. M., Christensen, J. J., Ottestad, I. O., & Holven, K. B. (2024) · BMC Geriatrics · doi:10.1186/s12877-024-04690-2 · Cited by 17
“This categorization of frailty in home-dwelling elderly people is in agreement with Rockwood et al. [16] and used in previous studies to define a frailty cut-off [17–20].”
ResultFrailty index associated with all-cause mortality, long-term institutionalization, and hip fracture
Kim, Y., Choe, Y., Park, J. H., Kim, S. Y., Won, C.-W., & Hwang, H. (2019) · European Geriatric Medicine · doi:10.1007/s41999-019-00196-y · Cited by 17
Developing a sensor-based mobile application for in-home frailty assessment: a qualitative study
Blinka, M. D., Buta, B. J., Bader, K. D., Hanley, C. L., Schoenborn, N. L., McNabney, M., & Xue, Q. (2021) · BMC Geriatrics · doi:10.1186/s12877-021-02041-z · Cited by 17
Vergara, I., Mateo‐Abad, M., Saucedo-Figueredo, M. C., Machón, M., Montiel‐Luque, A., Vrotsou, K., del Val, M. A. N., Díez-Ruiz, A., Güell, C., Matheu, A., et al. (2019) · BMC Geriatrics · doi:10.1186/s12877-019-1354-1 · Cited by 19
Prevalence of Frailty and Associations with Oral Anticoagulant Prescribing in Atrial Fibrillation
Sanghai, S., Liu, W., Wang, W., Rongali, S., Orkaby, A. R., Saczynski, J. S., Rose, A. J., Kapoor, A., Li, W., Yu, H., et al. (2021) · Journal of General Internal Medicine · doi:10.1007/s11606-021-06834-1 · Cited by 17
“0001 Body mass index category <25 19,873 (23) 7036 (20) 25–30 26,404 (31) 12,092 (34) 31–35 19,495 (23) 8916 (25) >35 17,980 (21) 7,164 (20) <.”
InfluentialRomero‐Ortuño, R., Hartley, P., Kenny, R. A., & O’Halloran, A. M. (2021) · European Geriatric Medicine · doi:10.1007/s41999-021-00570-9 · Cited by 17
“77) for the FI, which is consistent with our result that FRAIL had the lowest and FI the highest PPV, although in their study AUCs for FP and CFS were indistinguishable [5].”
InfluentialChrischilles, E. A., Schneider, K. M., Schroeder, M. C., Letuchy, E. M., Wallace, R. B., Robinson, J. G., & Brooks, J. M. (2016) · Journal of the American Geriatrics Society · doi:10.1111/jgs.13953 · Cited by 17
Frailty in patients with acute myeloid leukaemia, conceptual misapprehension of chronological age
Umit, E. G., Baysal, M., & Demir, A. M. (2018) · European Journal of Cancer Care · doi:10.1111/ecc.12810 · Cited by 17
Nguyên, Q. D., Moodie, E. E. M., Keezer, M. R., & Wolfson, C. M. (2021) · The Journals of Gerontology Series A · doi:10.1093/gerona/glab161 · Cited by 18
Cognitive Frailty as a Predictor of Mortality in Older Adults: A Longitudinal Study in Peru
Young, D. A. V. T., Salazar-Talla, L., Cuba-Ruiz, S., Urrunaga‐Pastor, D., Runzer-Colmenares, F. M., & Parodi, J. F. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.910005 · Cited by 16
“(1) Exhaustion: defined using the following questions from the geriatric depression scale (35, 36): (a) Do you feel full of energy?; (b) Do you feel that you cannot go on?; (c) Do you feel that everything you do is an effort? Exhaustion was considered with two or more positive responses (37); (2) Weight loss: defined…”
BackgroundMethodUruri-Cupi, K., Oliva-Zapata, F., Salazar-Talla, L., Cuba-Ruiz, S., Urrunaga‐Pastor, D., Runzer-Colmenares, F. M., & Parodi, J. F. (2022) · The journal of nutrition health & aging · doi:10.1007/s12603-022-1844-2 · Cited by 16
“…(assessed using the Edmonton Frailty Scale (28)), sedentary lifestyle (defined by a score less than or equal to 64 on the Physical Activity Scale for the Elderly (PASE) (29, 30) and overweight or obesity (defined by a body mass index greater than or equal to 25 kg/m 2 and 30 kg/m 2 , respectively).”
An, S., Ouyang, W., Wang, S., Yuan, J., & Zhen, X. (2023) · SSM - Population Health · doi:10.1016/j.ssmph.2023.101497 · Cited by 16
“The exclusion criteria were as follows: (1) aged less than 45 years old or without age information, (2) missing values of marital status and FI indicators more than 20% (Theou et al., 2013), and (3) participation in only one wave (2015 or 2018).”
BackgroundO’Donovan, M. R., Devleesschauwer, B., Sezgin, D., Liew, A., Kabir, Z., & Ó’Caoimh, R. (2023) · Age and Ageing · doi:10.1093/ageing/afad214 · Cited by 17
A scoping review of the measurement and analysis of frailty in randomised controlled trials
Sun, Y., Witham, M. D., Clegg, A. P., Taylor, R. S., Dibben, G. O., McAllister, D., & Hanlon, P. (2024) · Age and Ageing · doi:10.1093/ageing/afae258 · Cited by 19
“Different frailty measures identify different individuals as living with frailty [11, 19].”
Seiffert, P., Derejczyk, J., Kawa, J., Marcisz, C., Czernek, M., Szymszal, J., Kapko, W., Bugdol, M. N., Torbus, A., & Stȩpień-Wyrobiec, O. (2017) · Biogerontology · doi:10.1007/s10522-017-9716-6 · Cited by 16
Using elastic nets to estimate frailty burden from routinely collected national aged care data
Moldovan, M. V., Khadka, J., Visvanathan, R., Wesselingh, S. L., & Inacio, M. C. S. (2019) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocz210 · Cited by 16
“It has already been suggested that weighted frailty measures perform better in predicting adverse outcomes as compared to their unweighted versions.(41,42) In our study, we directly compared 2 alternative unweighted versions of a frailty measure with their weighted versions and concluded that weighted frailty scores p…”
BackgroundMaguire, F., Romero‐Ortuño, R., O’Connor, J. D., Reilly, R. B., Knight, S. P., & Kenny, R. A. (2020) · The Journals of Gerontology Series A · doi:10.1093/gerona/glaa315 · Cited by 16
“In keeping with frailty being a predictor of mortality (27), early impairment in the vector of HR changes during orthostasis (within the same temporal window—10 to 20 seconds) is a risk factor for cardiovascular disease and for all-cause mortality (28,29).”
BackgroundHoogendijk, E. O., Muntinga, M. E., de Breij, S., Huisman, M. A., & Klokgieters, S. S. (2021) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-021-01169-9 · Cited by 16
Ugarte-Gil, M. F., Dubey, J., McGwin, G., Reveille, J. D., Vilá, L. M., & Alarcón, G. S. (2022) · Arthritis Care & Research · doi:10.1002/acr.24878 · Cited by 16
“Previous reports support the predictability of the frailty indices even when some items are excluded, as long as a significant number of deficits are included (usually >30) (6,8,14).”
Season of birth, health and aging
Abeliansky, A. L., & Holger Strulik, B. (2019) · Economics & Human Biology · doi:10.1016/j.ehb.2019.100812 · Cited by 16
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Self-citationThe impact of functional dependence and related surgical complications on postoperative mortality
Clifton, J. C., Engoren, M., Shotwell, M. S., Martin, B. J., Clemens, E. M., Guillamondegui, O. D., & Freundlich, R. E. (2022) · Journal of Medical Systems · doi:10.1007/s10916-021-01779-8 · Cited by 16
Sensory and motor correlates of frailty: dissociation between frailty phenotype and frailty index
Beier, F., Löffler, M., Nees, F., Hausner, L., Frölich, L., & Flor, H. (2022) · BMC Geriatrics · doi:10.1186/s12877-022-03416-6 · Cited by 15
“Together, our results support the perspective that both frailty instruments share some common characteristics but also slightly differ from each other in detecting frailty in the same population [8, 9, 44], raising the question as to the characteristic correlates of the two frailty concepts.”
BackgroundMethodResultInfluentialQin, Y.-N., & Zheng, X. (2023) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-023-01165-z · Cited by 16
Ibrahim, K., Mullee, M., Cox, N. J., Russell, C., Baxter, M. A., Tilley, S., Yao, G., Zhu, S., & Roberts, H. C. (2021) · Age and Ageing · doi:10.1093/ageing/afab252 · Cited by 15
“There is no consensus on the best measure of frailty with many tools currently available [11], but two major definitions with proposed assessment tools have emerged over the past decade: the fried frailty phenotype (FFP) and the Frailty Index (FI; [12]).”
Braun, T., Thiel, C., Ziller, C., Rasche, J., Bahns, C., Happe, L., Retzmann, T., & Grüneberg, C. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-027768 · Cited by 15
“It is likely that especially older people and patients with higher levels of frailty might have refused participation, as reported by others.(46) However, we reached the a priori defined sample size of 250 participants, which is higher than in some,(15) 47 but lower than in most other studies on the prevalence of frai…”
Cross‐cultural adaptation of the FRAIL scale for critically ill patients in Spain
Arias-Rivera, S., Moro‐Tejedor, M. N., Raurell‐Torredà, M., Cortés‐Puch, I., Frutos–Vivar, F., Vázquez, C. A., Sánchez-Sánchez, M. M., Sánchez-Izquierdo, R., Oteiza‐López, L., López‐Cuenca, S., et al. (2023) · Nursing Open · doi:10.1002/nop2.2011 · Cited by 14
“The fact that there are up to 67 heterogeneous frailty assessment scales (Buta et al., 2016) makes it challenging to know the prevalence of frailty and its impact on society (Theou et al., 2013).”
BackgroundImpact of recipient functional status on 1-year liver transplant outcomes
Dolgin, N. H., Movahedi, B., Anderson, F. A., Brüggenwirth, I. M. A., Martins, P. N. A., & Bozorgzadeh, A. (2019) · World Journal of Transplantation · doi:10.5500/wjt.v9.i7.145 · Cited by 14
Low Energy Trauma in Older Persons: Where to Next?
Chehade, M. J., Gill, T. K., & Visvanathan, R. (2015) · The Open Orthopaedics Journal · doi:10.2174/1874325001509010361 · Cited by 14
“There are many recent reports of efforts to achieve this [27-32].”
Vascular risk assessment in older adults without a history of cardiovascular disease
Bambrick, P., Tan, W. S., Mulcahy, R., Pope, G., & Cooke, J. P. (2016) · Experimental Gerontology · doi:10.1016/j.exger.2016.03.002 · Cited by 15
Hegendörfer, E., Vaes, B., Pottelbergh, G. V., Matheï, C., Verbakel, J. Y. J., & Degryse, J. (2019) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2019.08.029 · Cited by 14
Frailty and Effects of Semaglutide in Obesity-Related HFpEF
Pandey, A., Kitzman, D. W., Chinnakondepalli, K., Patel, S., Borlaug, B. A., Butler, J., Davies, M. J., Shah, S. J., Verma, S., Rönnbäck, C., et al. (2025) · JACC Heart Failure · doi:10.1016/j.jchf.2025.102610 · Cited by 16
Akner, G. (2022) · Aging and Disease · doi:10.14336/ad.2022.0506 · Cited by 13
“Applying different frailty criteria to the same group of elderly patients has been shown to result in great variance in the prevalence of frailty, 36–88% [12] or 6–44% [13].”
BackgroundHow frail is frail in oncology studies? A scoping review
Fletcher, J. A., Logan, B., Reid, N., Gordon, E. H., Ladwa, R., & Hubbard, R. E. (2023) · BMC Cancer · doi:10.1186/s12885-023-10933-z · Cited by 12
Franconi, I., Theou, O., Wallace, L. M. K., Malagoli, A., Mussini, C., Rockwood, K. J., & Guaraldi, G. (2018) · PLoS ONE · doi:10.1371/journal.pone.0201394 · Cited by 13
Self-citationZago, M., Bozzo, S., Carrara, G., & Mariani, D. (2017) · Chirurgia · doi:10.21614/chirurgia.112.5.538 · Cited by 13
“One of the main concerns of modern surgical practice and a field of research is the appropriate selection of elder and elder-old patients for surgery, avoiding futile treatment (23-25).”
BackgroundWesson, D. E., Mathur, V. S., & Tangri, N. (2022) · American Journal of Nephrology · doi:10.1159/000526679 · Cited by 14
Physical Exercise Intervention Characteristics and Outcomes in Frail and Pre-Frail Older Adults
Pareja, M., Espinosa, D., Losada, J. J., & Ordoñez‐Mora, L. T. (2024) · Geriatrics · doi:10.3390/geriatrics9060163 · Cited by 12
“This scale has demonstrated a strong predictive capacity for two-year mortality [64] and has been both validated and applied in multiple countries [65,66].”
Frailty in Lung Transplantation: Candidate Assessment and Optimization
Agarwal, A., & Neujahr, D. C. (2021) · Transplantation · doi:10.1097/tp.0000000000003671 · Cited by 12
Prevalence and incidence of frailty among community-dwelling older adults in Slovenia
Jazbar, J., Pišek, Š., Locatelli, I., & Kos, M. (2021) · Slovenian Journal of Public Health · doi:10.2478/sjph-2021-0027 · Cited by 12
“In the current study we used the previously published and validated scale of frailty phenotype from SHARE data (16, 17); details are presented in Appendix A.”
MethodFrailty in relation to sedentary behaviours and moderate-vigorous intensity physical activity
Blodgett, J. M., Theou, O., Kirkland, S., Andreou, P., & Rockwood, K. J. (2014) · Reviews in Clinical Gerontology · doi:10.1017/s0959259814000124 · Cited by 12
Self-citationGarm, A., Park, G. H., & Song, X. (2018) · Medical & Clinical Reviews · doi:10.21767/2471-299x.1000051 · Cited by 10
“Frailty can be operationalized in many ways and several methods have been commonly used to assess frailty [11-12].”
MethodGait speed as a predictor of mortality in older men with cancer: A longitudinal study in Peru
Salazar, E. P. D., Barrueto-Deza, J. L., Urrunaga‐Pastor, D., Runzer-Colmenares, F. M., & Parodi, J. F. (2022) · Heliyon · doi:10.1016/j.heliyon.2022.e08862 · Cited by 12
Sarwar, T., Yepes, A. J., Zhang, X., Chan, J., Hudson, I. L., Evans, S. B., & Cavedon, L. (2022) · BMC Geriatrics · doi:10.1186/s12877-022-03616-0 · Cited by 11
Sert, E. T., Kokulu, K., Mutlu, H., & Yortanlı, B. Ç. (2023) · Journal of Emergency Medicine · doi:10.1016/j.jemermed.2023.08.020 · Cited by 11
Bai, C., Al‐Ani, M. A., Amini, S., Tighe, P. J., Price, C. C., Manini, T. M., & Mardini, M. (2023) · Journal of Intelligent Information Systems · doi:10.1007/s10844-023-00818-9 · Cited by 11
“…illustration of the comparison between the ML method and the accumulation of deficits approach are a variety of cut-points in the literature, ranging from 0.21 to 0.25 (Theou et al., 2013; Pajewski et al., 2016; Kim et al., 2019), and there is no universally accepted index threshold across studies.”
InfluentialBålsrud, P., Ulven, S. M., Ottestad, I. O., Retterstøl, K., Schwab, U., & Holven, K. B. (2024) · GeroScience · doi:10.1007/s11357-024-01279-w · Cited by 13
Risk Analysis Index Frailty Score as a Predictor of Otolaryngology Surgical Outcomes
Evans, L. K., Moffatt, C., Niknejad, K., Yang, H., Kodaverdian, L. C., Soliman, S., Orozco, F. R., & Chhetri, D. K. (2024) · Otolaryngology · doi:10.1002/ohn.899 · Cited by 11
“18 The RAI ‐”
Scale-based screening and assessment of age-related frailty
Wang, X., Zhang, Y.-H., Meng, C., Fan, L., Wei, L., Li, Y., Liu, X., & Lv, S. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1424613 · Cited by 11
“GFI has been widely used in many countries such as Germany, Italy, France, and so on, and it is suitable for use in different assessment environments, such as communities, nursing homes, and healthcare facilities (97).”
Uyar, G. C., & Kılıç, M. K. (2024) · BMC Geriatrics · doi:10.1186/s12877-024-05643-5 · Cited by 11
O’Donovan, M. R., Sezgin, D., Ó’Caoimh, R., & Liew, A. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17249535 · Cited by 11
“Cognitive impairment was measured based on previously described criteria [35], where questions on mathematical performance (five questions on percentages), verbal fluency (animal naming), and delayed recall were used, and cognitive impairment was defined as having all three of the following: an incorrect maths questio…”
MethodUse of the Tilburg frailty indicator in longitudinal studies with older adults: A scoping review
Lee, J., Kim, G. S., Kim, S., Park, J., Lee, H., Shim, M., Ryu, G. W., Park, J., & Yoo, J. (2023) · Journal of Advanced Nursing · doi:10.1111/jan.15675 · Cited by 11
Cesari, M. (2017) · Annals of Geriatric Medicine and Research · doi:10.4235/agmr.2017.21.2.42 · Cited by 11
van der Ploeg, T., & Gobbens, R. J. J. (2022) · JMIR Medical Informatics · doi:10.2196/31480 · Cited by 9
“Five studies have examined the predictive value of the TFI for mortality [16-20].”
BackgroundResultVasquez-Goñi, G. A. J., Romero, B. M. P., Urrunaga‐Pastor, D., Runzer-Colmenares, F. M., & Parodi, J. F. (2021) · Heliyon · doi:10.1016/j.heliyon.2021.e08640 · Cited by 10
“Social support was assessed using the Edmonton frailty scale (no, yes) [28].”
MethodStrang, P. M., & Schultz, T. (2023) · Current Oncology · doi:10.3390/curroncol30070486 · Cited by 10
“Several instruments are available for prospective frailty assessments, of which the Clinical Frailty Scale and Frailty Phenotype are the most commonly used tools in acute care settings [13,14].”
BackgroundKohn, J. N., Lobo, J. D., Troyer, E. A., Ang, G., Wilson, K. L., Walker, A., Spoon, C., Pruitt, C., Tibiriçá, L., Pung, M. A., et al. (2023) · Aging Clinical and Experimental Research · doi:10.1007/s40520-023-02504-w · Cited by 10
“While operationalization of FI varies across studies, the FI uses standard criteria [12], is robust to floor and ceiling effects, and performs similarly to the frailty phenotype measure in predicting adverse clinical outcomes [14].”
Goshen, A., Goldbourt, U., Benyamini, Y., Shimony, T., Keinan‐Boker, L., & Gerber, Y. (2023) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2023.08.015 · Cited by 10
Kang, M., Jung, H.-W., & Kim, B. (2024) · The Korean Journal of Internal Medicine · doi:10.3904/kjim.2024.050 · Cited by 10
Kasa, A. S., Drury, P., Chang, H., Lee, S., & Traynor, V. (2023) · Clinical Interventions in Aging · doi:10.2147/cia.s416942 · Cited by 11
“This finding is in line with reports from various studies which reported that the TFI contains the majority of important frailty items.(22,72) However, it was noted that some important items were missed from a study conducted in Denmark.”
ResultLaterza, V., Covino, M., Schena, C. A., Russo, A., Salini, S., Polla, D. A. D., de’Angelis, N., Quero, G., Tondolo, V., Greca, A. L., et al. (2023) · Journal of Gastrointestinal Surgery · doi:10.1007/s11605-023-05820-8 · Cited by 10
Frailty: a term with many meanings and a growing priority for community nurses
Wallington, S. L. (2016) · British Journal of Community Nursing · doi:10.12968/bjcn.2016.21.8.385 · Cited by 10
Veld, L. P. M. O. H., van Rossum, E., Kempen, G. I. J. M., Beurskens, A. J. H. M., Hajema, K., & de Vet, H. C. W. (2019) · The Journal of Frailty & Aging · doi:10.14283/jfa.2019.17 · Cited by 10
“Nevertheless the AUCs of frailty instruments are generally not very convincing (6).”
Zhao, F., Tang, B., Liu, X., Weng, W., Wang, B., Wang, Y., Zhang, Z., & Zhang, L. (2021) · Age and Ageing · doi:10.1093/ageing/afab186 · Cited by 10
The Application of Digital Frailty Screening to Triage Nonhealing and Complex Wounds
Mishra, R. K., Bara, R. O., Zulbaran‐Rojas, A., Park, C., Fernando, M. E., Ross, J. A., Lepow, B. D., & Najafi, B. (2022) · Journal of Diabetes Science and Technology · doi:10.1177/19322968221111194 · Cited by 10
“23,24 25-27 The FM works by quantifying weakness, slow-ness, rigidity, and exhaustion over a 20-second repetitive elbow flexion-extension exercise using a wrist-worn sensor.”
BackgroundManaging Syncope in the Elderly: The Not So Simple Faint in Aging Patients
Solbiati, M., Sheldon, R. S., & Seifer, C. M. (2016) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2016.04.005 · Cited by 10
Feng, G., Liu, W., Liu, M., Tang, S., Lu, Y., & Hou, T. (2019) · BMC Geriatrics · doi:10.1186/s12877-019-1314-9 · Cited by 10
2017 Update in perioperative medicine: 6 questions answered
Munyon, R., Cohn, S. L., Slawski, B. A., Smetana, G. W., & Pfeifer, K. J. (2017) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.84a.17068 · Cited by 9
Oberndorfer, M., Mogg, C., Haider, S., Grabovac, I., Drgac, D., & Dorner, T. E. (2021) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2021-216637 · Cited by 10
Castro, M. D. L., Alves, M., Martins, A. R., Papoila, A. L., Botelho, M. A., & Fragata, J. (2023) · Revista Portuguesa de Cardiologia · doi:10.1016/j.repc.2022.03.009 · Cited by 9
Rivasi, G., Ceolin, L., Turrin, G., Tortù, V., D’Andria, M., Testa, G. D., Montali, S., Tonarelli, F., Brunetti, E., Bo, M., et al. (2023) · Journal of Hypertension · doi:10.1097/hjh.0000000000003559 · Cited by 9
“A similar heterogeneity was described in a secondary analysis of the SHARE study, wherein eight frailty scales were compared reporting widely different estimates for the prevalence of frailty [55].”
ResultAssessing Global Frailty Scores: Development of a Global Burden of Disease-Frailty Index (GBD-FI)
O’Donovan, M. R., Sezgin, D., Kabir, Z., Liew, A., & Ó’Caoimh, R. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17165695 · Cited by 9
“[11]; a frailty index from the Beijing Longitudinal Study of Aging (FIBLSA) [33]; the Comprehensive Geriatric Assessment frailty index (FI-CGA) [21]; a 70-item Frailty Index (SHARE-FI) [34] the National Long Term Care Survey Frailty Index (NLTCS) [35]; and the Electronic frailty index (eFI) [17], the 11-item modified…”
MethodInfluentialRisk Factors for Frailty in Critical Care Survivors: A secondary analysis
Kang, J., Jeong, Y. J., Jang, J. H., & Lee, M. (2020) · Intensive and Critical Care Nursing · doi:10.1016/j.iccn.2020.102981 · Cited by 9
Zil‐E‐Ali, A., Patel, K., Goldfarb, M., & Aziz, F. (2022) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2022.01.122 · Cited by 9
Travers, J., Romero‐Ortuño, R., Power, D., Doran, P., Langan, J., MacNamara, F., McCormack, D., McDermott, C. J., McEntire, J., McKiernan, J., et al. (2020) · HRB Open Research · doi:10.12688/hrbopenres.13188.1 · Cited by 9
“The prevalence of frailty is estimated at 11% in adults aged ≥ 50 years and increases to some 50% in those >80 years of age 4,5 .”
Robbins, G. T., Yih, E. T., Chou, R. C., Gundersen, A. I., Schnieder, J. C., Bean, J. F., & ZAFONTE, R. D. (2019) · Handbook of clinical neurology · doi:10.1016/b978-0-12-804766-8.00029-7 · Cited by 9
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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