| Keywords [eng] |
frailty, assessment tools, older adults, FRAILTOOLS Project, feasibility, comprehensive geriatric assessment, different clinical settings, Primary care setting, Hospital setting, Emergency Department setting, Long-Term Care setting |
| Abstract [eng] |
Objective: Several frailty assessment tools have been developed in recent years, but there is no gold standard that tells which are most suitable in different clinical settings based on their sensitivity, specificity, applicability, and feasibility. Aim: This literature review aims to determine which frailty assessment tools are most appropriate for different clinical settings—namely, primary care, hospital/emergency departments (ED), and nursing homes—by evaluating their sensitivity, specificity, applicability, and feasibility. Design: Literature review Methods: Searches were conducted in PubMed, Scopus, and Elsevier using database-specific search terms such as “elderly,” “older adult,” “frailty,” “frail tool,” “frailty screening,” and related keywords; manual searches of guideline websites were also performed. Using the PICOS framework, studies published in English over the past 11 years (2014–2025) that focused on patients aged ≥65 years (excluding terminally ill individuals) were included. Results: The findings reveal marked heterogeneity among frailty instruments, likely because different scales capture distinct components of frailty. In primary care, where time constraints and the need for self-administered tools prevail, the PRISMA-7 and EASY-Care TOS are recommended. In hospital settings, the Frailty Index (FI) and the FRAIL scale effectively predict mortality and hospitalization risks, aiding clinical decision-making. In EDs, rapid frailty detection is critical; thus, the PRISMA-7 is preferred due to its optimal balance of sensitivity and specificity. The FRAIL-NH scale is suited for broad screening in long-term care settings, while the FI is better for in-depth, individualized assessments. Conclusion: Overall, 15 studies from America, Europe, Asia, and Australia were analyzed. Although direct comparisons are challenging because many studies focus on a single tool, the evidence supports a two-step approach involving an initial brief screening questionnaire to detect frailty, followed by a more detailed assessment to determine care needs at the individual level. Further research is needed to enhance the clinical relevance of guidelines for frailty identification and to standardize the use of these instruments in both clinical and research settings. |
