Title: Screening instruments for frailty: a horizon scanning report
Authors: Daniels, Liesbeth
Deckx, Laura
Plüddeman, Annette
Buntinx, Frank
Issue Date: 2012
Conference: Cancer and Primary Care Research International Network (Ca-PRI) international Annual Meeting edition:5 location:Cleveland, USA date:5 - 7 June
Article number: 28
Abstract: Introduction: Frailty is a commonly used term indicating older persons at increased risk for adverse
outcomes such as onset of disability, morbidity, institutionalization or mortality. A screening tool could
be used to identify those patients who would benefit from further assessment by full Comprehensive
Geriatric Assessment. General practitioners could integrate these short screening tools in their daily
practice, and continue or refer if further assessment is needed.
Research question: What is the diagnostic value of screening instruments for frailty (in primary
Methods: A comprehensive literature search was performed in Medline, Embase, Medion, Cochrane
Library, TRIP and NHS Evidence. Instruments that were too time-consuming (more like a CGA) or
focused on only one aspect (e.g. Activities of Daily Life) were excluded. Other exclusion criteria were:
no diagnostic indicators reported, screening tool based on clinical judgment or administrative data,
low quality of cohort study.
Results: Our search retrieved 42 screening instruments for frailty; 16 after exclusion. 6 instruments
were tested in a primary care setting and/or in a non-hospital population, 9 in an ED/hospital setting,
and 4 in cancer patients. In 2008, the European, Canadian and American Geriatric Advisory Panel
(GAP), through a complete review of the literature on frailty, sketched out the “ideal” screening tool
for frailty. According to their recommendations, it should include five components: fatigue reported by
patient, physical functioning, walking, number of co-morbidities and nutritional status. None of the
tools covers all 5 domains.
Conclusion: Because there is no gold standard to measure frailty, and because the instruments
have been tested in different settings and with different outcome measures, it seems impossible to
select one screening tool for the identification of frail older people based on the current studies. 8
instruments seem interesting to be further explored in a prospective study: SHARE-FI, TFI, GFI, 7-
item Rowland, G8, VES-13, ISAR, aCGA.
Publication status: published
KU Leuven publication type: IMa
Appears in Collections:Academic Center for General Practice

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