Background and objectives

Frailty has been investigated for decades with a proliferation of frailty instruments attributed to many existing conceptual models and operational criteria. The purpose of this systematic review was to understand how instruments were developed to assess frailty in community dwelling older adults.

Research design and methods

This review followed standard conduct, reporting, and quality assessment guidelines. Articles published in English that described instruments used to measure frailty in community dwelling older adults 65 years of age or older; and instruments developed for research purposes or in clinical practice were included. MEDLINE, CINAHL, and EMBASE (March 2022) and Abstracts in Social Gerontology (March 2020) were searched.

Results

A total of 32 frailty instruments were identified with self-reported, performance-based, or researcher/clinician observed items. Common characteristics across instruments were categorized as follows: frailty conceptualized as a state or a syndrome; frailty operationalized as continuous, categorical, or dichotomous; and instruments developed for clinical, research or both purposes. All items in the instruments were developed based on theories of frailty; some were informed by panels of experts; and others used statistical methods to compare variables across instruments.

Discussion and implications

Results from this review will assist clinicians/researchers select appropriate instruments to assess frailty in older adults living in the community. It is time to pause on the development of more instruments. Instead, efforts must be directed toward advancing research and clinical practice using existing validated instruments to inform clinical decision-making and health care coordination to avoid, delay, or manage frailty in the community.

Tweetable abstract

More research and clinical practice using existing validated frailty instruments to assess frailty in older adults living in the community is a must!

中文翻译：

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评估社区居住老年人虚弱的工具：系统评价

背景和目标

脆弱性已经被研究了几十年，由于许多现有的概念模型和操作标准，脆弱性工具的激增。这项系统评价的目的是了解如何开发工具来评估社区居住老年人的脆弱性。

研究设计与方法

该审查遵循标准的行为、报告和质量评估指南。以英文发表的文章，描述了用于测量 65 岁或以上社区居住老年人体弱程度的仪器；包括为研究目的或临床实践而开发的仪器。检索了 MEDLINE、CINAHL 和 EMBASE（2022 年 3 月）和社会老年学摘要（2020 年 3 月）。

结果

共有 32 种脆弱的仪器被确定为自我报告的、基于性能的或研究人员/临床医生观察的项目。跨工具的共同特征分类如下：虚弱概念化为一种状态或综合征；脆弱可操作为连续的、分类的或二分法的；以及为临床、研究或两者目的而开发的仪器。文书中的所有项目都是根据虚弱理论开发的；有些是由专家小组通知的；和其他人使用统计方法来比较不同工具的变量。

讨论和影响

本次审查的结果将帮助临床医生/研究人员选择合适的工具来评估社区老年人的脆弱性。现在是暂停开发更多工具的时候了。相反，必须努力使用现有的经过验证的工具来推进研究和临床实践，为临床决策和医疗保健协调提供信息，以避免、延迟或管理社区的脆弱性。

可推文摘要

必须进行更多的研究和临床实践，使用现有经过验证的衰弱仪器来评估社区老年人的衰弱！