Frailty syndrome in the elderly: a review of the literature on assessment tools and rating scales

Article Sidebar

PDF (Português (Portugal))
Published: Aug 8, 2021
DOI: https://doi.org/10.17060/ijodaep.2021.n1.v2.2081
Keywords:
frailty elderly review assessments screening clinical scales tools

Main Article Content

Mário Pinto
Instituto de Ciências Biomédicas Abel Salazar (ICBAS). Porto Portosintesis
Mariana Pinto
Nutricionista unidade hemodialise, Porto Isabel Alçada c Arranhado Universidade Atlântica

Abstract

Background: The profile of a frail patient corresponds to an elderly person, with multimorbidity, an unstable and often disabled health status. Frailty is a progressive clinical entity that can be prevented and treated, and is a health concern and priority. For its diagnosis, it is essential to have available a valid, reliable, easily applicable instrument that can predict the risk of adverse outcomes. Objective: This study aims to identify instruments specifically developed to assess and stratify frailty among the elderly based on information collected by healthcare professionals and to identify the one that is easiest to use, according to criteria established by the Consensus Standards for the selection of measurement instruments in healthcare. (COSMIN) Methodology: A literature review was conducted between January 1, 2013 and January 1, 2018. The research was conducted by two investigators, according to the Preferred Reporting Items for Systematic Reviews (PRISMA). Medline, PubMed, Embase, LILACS and Cochrane Library databases with no language restriction were used, and descriptors were defined and organized. PICO (Population Implementation Comparator Outcomes) was used. We defined a priori the criteria to be followed regarding the type of studies, diagnostic measures, selection, sample size and the presence of biases. The main characteristics of each instrument were studied, evaluating its potential clinical use. Results: From the 881 selected articles, 16 studies with 26 frailty assessment tools were identified. The tools were classified as uniand multidimensional. The uni-dimensional tools are oriented towards the physical domain and functionality and biological/physiological status, while the multidimensional assessments, are based on the analysis of the interactions of physical, psychological and social domains of human functioning. Nine instruments were studied and compared, of which only 3 are clinical and of these, 2 stratify frailty. Conclusion: There is still no internationally agreed upon standard measure to assess frailty; some measures are more suitable for screening in hospitals and others in the community. The domains we observed in the instruments studied, are mainly uni- (physical/ clinical) and multidimensional (cognitive, psychological, social and environmental). Given the complexity of diagnosing frailty and the elderly, the combined use of physical and multidisciplinary screening tools is recommended.

Downloads

Download data is not yet available.

Article Details

How to Cite
Pinto, M., & Pinto, M. (2021). Frailty syndrome in the elderly: a review of the literature on assessment tools and rating scales. International Journal of Developmental and Educational Psychology. Revista INFAD De Psicología., 2(1), 385–400. https://doi.org/10.17060/ijodaep.2021.n1.v2.2081
Issue
Vol. 2 No. 1 (2021): PSYCHOLOGY AND POSITIVE GROWTH. COPING WITH THE DIFFICULTY IN A MATURE WAY: THE RESPONSE TO COVID 19
Section
Articles
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Authors who publish with this journal agree to the following terms:
 
a. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to copy and redistribute the material in any medium or format under the following terms:

 

Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.

NonCommercial — You may not use the material for commercial purposes.

NoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.

 
b. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
 
c. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
 
The authors are responsible to obtain the appropriate permissions to reproduce material (text, images or graphics) from other publications and to quote their origin correctly.
 

References

Direção Geral de Saúde. Depressão e outras Perturbações Mentais Comuns. Direção-Geral da Saúde. 2017;1–104.

Turismo TDO, Demogr S, Regi NAS, Portuguesas ES, Territorial R, Territorial R, et al. Retrato Territorial de Portugal Edição 2017. 2017;1–18.

Morley JE, Vellas B, Abellan van Kan G, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: A call to action. J Am Med Dir Assoc [Internet]. 2013;14(6):392–7. Available from: http://dx.doi.org/10.1016/j.jamda.2013.03.022

Morley JE, Vellas B, Kan GA van, al. et. Frailty consensus: A call to action. J Am Med Dir Assoc. 2013;14:392–7.

Gale CR, Westbury L, Cooper C. Social isolation and loneliness as risk factors for the progression of frailty: The English Longitudinal Study of Ageing. Age Ageing. 2018;47(3):392–7.

Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J et al, Fried LP, Tangen CM, Walston J et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.

Topinková E. Aging, disability and frailty. Ann Nutr Metab. 2008;52(SUPPL. 1):6–11. Direção Geral de Saúde. Depressão e outras Perturbações Mentais Comuns. Direção-Geral da Saúde. 2017;1–104.

Turismo TDO, Demogr S, Regi NAS, Portuguesas ES, Territorial R, Territorial R, et al. Retrato Territorial de Portugal Edição 2017. 2017;1–18.

Morley JE, Vellas B, Abellan van Kan G, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: A call to action. J Am Med Dir Assoc [Internet]. 2013;14(6):392–7. Available from: http://dx.doi.org/10.1016/j.jamda.2013.03.022

Morley JE, Vellas B, Kan GA van, al. et. Frailty consensus: A call to action. J Am Med Dir Assoc. 2013;14:392–7.

Gale CR, Westbury L, Cooper C. Social isolation and loneliness as risk factors for the progression of frailty: The English Longitudinal Study of Ageing. Age Ageing. 2018;47(3):392–7.

Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J et al, Fried LP, Tangen CM, Walston J et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.

Topinková E. Aging, disability and frailty. Ann Nutr Metab. 2008;52(SUPPL. 1):6–11. Direção Geral de Saúde. Depressão e outras Perturbações Mentais Comuns. Direção-Geral da Saúde. 2017;1–104.

Turismo TDO, Demogr S, Regi NAS, Portuguesas ES, Territorial R, Territorial R, et al. Retrato Territorial de Portugal Edição 2017. 2017;1–18.

Morley JE, Vellas B, Abellan van Kan G, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: A call to action. J Am Med Dir Assoc [Internet]. 2013;14(6):392–7. Available from: http://dx.doi.org/10.1016/j.jamda.2013.03.022

Morley JE, Vellas B, Kan GA van, al. et. Frailty consensus: A call to action. J Am Med Dir Assoc. 2013;14:392–7.

Gale CR, Westbury L, Cooper C. Social isolation and loneliness as risk factors for the progression of frailty: The English Longitudinal Study of Ageing. Age Ageing. 2018;47(3):392–7.

Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J et al, Fried LP, Tangen CM, Walston J et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.

Topinková E. Aging, disability and frailty. Ann Nutr Metab. 2008;52(SUPPL. 1):6–11.

Shamliyan T, Talley KMC, Ramakrishnan R, Kane RL. Association of frailty with survival: A systematic literature review. Ageing Research Reviews. 2013.

Rochat S, Cumming RG, Blyth F, Creasey H, Handelsman D, Le Couteur DG, et al. Frailty and use of health and community services by community-dwelling older men: The Concord Health And Ageing in Men Project. Age Ageing. 2010;39(2):228–33.

M.Gagesch, H-A.Bischoff-Ferrari BV. Head-to-head compariso of Fralty Prevalence by instroment in 5 DO-Heath countries,. 2018;1(July):3901295.

Sirven N, Rapp T. The cost of frailty in France. Eur J Heal Econ [Internet]. 2017 Mar;18(2):243–53. Available from: https://doi.org/10.1007/s10198-016-0772-7

Wyrko Z. CME ACUTE MEDICINE Frailty at the front door. Clin Med (Northfield Il).2015;15(4):377–81.

Dent E, Kowal P, Hoogendijk EO. Frailty measurement in research and clinical practice: A review. Eur J Intern Med [Internet]. 2016 Jun 1 [cited 2018 Feb 27];31:3–10. Available from: https://www.sciencedirect.com/science/article/pii/S0953620516300279

Rolland Y, Benetos A, Gentric A, Ankri J, Blanchard F, Bonnefoy M, et al. La fragilité de la personne âgée: un consensus bref de la Société française de gériatrie et gérontologie. Geriatr Psychol Neuropsychiatr Vieil. 2011;9(4):387–90.

Hyde Z, Flicker L, Almeida OP, Hankey GJ, McCaul KA, Chubb SAP, et al. Low free testosterone predicts frailty in older men: The health in men study. J Clin Endocrinol Metab. 2010;95(7):3165–72.

Rockwood K, Song X, MacKnight C, al. et. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005;173:489–95.

Archibald MM, Ambagtsheer R, Beilby J, Chehade MJ, Gill TK, Visvanathan R, et al. Perspectives of Frailty and Frailty Screening: Protocol for a Collaborative Knowledge Translation Approach and Qualitative Study of Stakeholder Understandings and Experiences. BMC Geriatr. 2017;

Huisingh-Scheetz M, Walston J. How should older adults with cancer be evaluated for frailty? Journal of Geriatric Oncology. 2017.

Sutton JL, Gould RL, Daley S, Coulson MC, Ward E V., Butler AM, et al. Psychometric properties of multicomponent tools designed to assess frailty in older adults: A systematic review. BMC Geriatr. 2016;16(1).

Fried LP, Tangen CM, Walston J, al. et. Frailty in older adults: Evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146–56.

Mitnitski AB, Mogilner AJ, Rockwood K. Accumulation of deficits as a proxy measure of aging. Sci World J. 2001;1:323–36.

Coelho T. Modelo integral de fragilidade do idoso (do constructo à avaliação Tilburg frailty indicator). 2014;118.

Rockwood K, Theou O, Mitnitski A. What are frailty instruments for? Vol. 44, Age and Ageing. 2015.

Roppolo M, Mulasso A, Gobbens RJ, Mosso CO, Rabaglietti E. A comparison between uni- and multidimensional frailty measures: Prevalence, functional status, and relationships with disability. Clin Interv Aging. 2015;10.

Wei Y, McGrath PJ, Hayden J, Kutcher S. Measurement properties of tools measuring mental health knowledge: A systematic review. BMC Psychiatry. 2016;

Mokkink LB, Prinsen CAC, Bouter LM, de Vet HCW, Terwee CB. The COnsensus-based standards for the selection of health measurement INstruments (COSMIN) and how to select an outcome measurement instrument. Brazilian J Phys Ther. 2016;20(2):105–13.

Lefebvre C, Glanville J, Wieland LS, Coles B, Weightman AL. Methodological developments in searching for studies for systematic reviews: past, present and future? Syst Rev [Internet]. 2013;2:78. Available from: https://www.scopus.com/inward/record.uri?eid=2-s2.0-84888333320&partnerID=40&md5=1bfa7344c017a96b16aa52a856b510cc

Part 1 - Finding the Best Clinical Evidence. 3(3):10–26.

Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. 2018;169(7):467–73.

Clegg A, Young J, Iliffe S, al. et. Frailty in elderly people. Lancet. 2013;381:752–62.

Indicate N. Newcastle-Ottawa Quality Assessment Form for Cohort Studies.: 17–8.

Donato H, Donato M. Etapas na Condução de uma Revisão Sistemática. Acta Med Port. 2019;32(3):227.

Zeng X, Zhang Y, Kwong JSW, Zhang C, Li S, Sun F, et al. The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: A systematic review. J Evid Based Med. 2015;8(1):2–10.

Kojima G. Frailty as a predictor of hospitalisation among community-dwelling older people: A systematic review and meta-analysis. Journal of Epidemiology and Community Health. 2016.

Green S. Cochrane Handbook for Systematic Cochrane Handbook for Systematic Reviews of. 2008;

Gobbens RJ, Assen MA van, Luijkx KG, al. et. The Tilburg Frailty Indicator: Psychometric properties. J Am Med Dir Assoc. 2010;11:344–55.

Hardy SE, Dubin JA, Holford TR, Gill TM. Transitions between States of Disability and Independence among Older Persons. 2005;161(6):575–84.

Gill TM, Gahbauer EA, Allore HG, Han L. Transitions between frailty states among communityliving older persons. Arch Intern Med. 2006;166:418–23.

Steptoe A, Shankar A, Demakakos P, Wardle J. Social isolation , loneliness , and all-cause mortality in older men and women. 2013;110(15):5797–801.