Frailty assessment utilization around the globe-a systematic review

Recent expert guidelines recommend that frailty assessments (FAs) encompass physical, functional, cognitive, social, and mental health domains. This systematic review examines FAs administered globally between 2015 to 2022 in geriatric participants (65 years and older) to characterize the parameters used to assess frailty.

Following PRISMA guidelines, we screened 3,859 articles and included 202 in the final analysis. FA parameters were coded into 45 health-related categories defined by the authors to evaluate the domains most frequently used.

Across 39 countries, 291 FAs were identified, with an average number of 17.36 parameters per instrument. Of the 4,995 total parameters analyzed, 22.32 % assessed functional health or physical performance. Cognitive, mental, and social health were assessed by only 6.09 %, 6.35 %, and 5.01 % of parameters, respectively.

FAs overwhelmingly measure functional and physical health parameters with limited attention to cognitive, mental, and social domains. This imbalance suggests that instruments may fall short of capturing the multidimensional nature of frailty as recommended by recent guidelines. By cataloging current FAs, their components, and the degree to which they reflect comprehensive frailty definitions, this review highlights the need for further research and refinement of FAs to ensure accurate, holistic assessment across diverse clinical settings.