Clinical Frailty Scale - frailty assessment and rehabilitation potential
Frailty assessment and rehabilitation potential
DOI:
https://doi.org/10.12775/JEHS.2024.71.51507Keywords
Geriatric Medicine, Ambulatory Care, Clinical Frailty Scale, Frailty, CFSAbstract
Background: Studies show a significant increase in frailty prevalence among older adults worldwide. Fortunately, several well-established and user-friendly screening tools can effectively identify frailty in older adults.
Objectives: This article examines the Clinical Frailty Scale's effectiveness in informing treatment decisions for older adults in ambulatory care settings, analyzing its potential to improve patient care.
Methods: On April 1, 2024, the PubMed database was searched for articles on the Clinical Frailty Scale in elderly patients. The 116 most pertinent and current articles, written in English and published within the past few years, were analyzed, and 38 were selected and categorized by content and topic.
Limitations: This study is limited because it is not a meta-analysis and thus does not examine the quality of the evidence presented in each article.
Conclusions: Frailty research has illuminated aging and its potential biological causes. The Clinical Frailty Scale effectively identifies vulnerable individuals. By using the CFS to assess frailty risk, healthcare providers can personalize treatment plans and improve overall care for older adults.
References
Church S, Rogers E, Rockwood K, Theou O. A scoping review of the Clinical Frailty Scale. BMC Geriatr. 2020 Oct 7;20(1):393. doi: 10.1186/s12877-020-01801-7. PMID: 33028215; PMCID: PMC7540438.
Xue QL. The frailty syndrome: definition and natural history. Clin Geriatr Med. 2011 Feb;27(1):1-15. doi: 10.1016/j.cger.2010.08.009. PMID: 21093718; PMCID: PMC3028599.
Kwak D, Thompson LV. Frailty: Past, present, and future? Sports Med Health Sci. 2020 Nov 30;3(1):1-10. doi: 10.1016/j.smhs.2020.11.005. PMID: 35782680; PMCID: PMC9219322.
Cesari M., Demougeot L., Boccalon H., et al. A self-reported screening tool for detecting community-dwelling older persons with frailty syndrome in the absence of mobility disability: the FiND questionnaire. PloS One. 2014;9(7) doi: 10.1371/journal.pone.0101745.
Thandi M, Wong ST, Aponte-Hao S, Grandy M, Mangin D, Singer A, Williamson T. Strategies for working across Canadian practice-based research and learning networks (PBRLNs) in primary care: focus on frailty. BMC Fam Pract. 2021 Nov 12;22(1):220. doi: 10.1186/s12875-021-01573-y. PMID: 34772356; PMCID: PMC8590340.
Sternberg SA, Schwartz AW, Karunananthan S, Bergman H, Clarfield AM. The identification of frailty: a systematic literature review. J Am Geriatr Soc. 2011;59(11):2129–2138. doi: 10.1111/j.1532-5415.2011.03597.x
Falk Erhag H, Guðnadóttir G, Alfredsson J, Cederholm T, Ekerstad N, Religa D, Nellgård B, Wilhelmson K. The Association Between the Clinical Frailty Scale and Adverse Health Outcomes in Older Adults in Acute Clinical Settings - A Systematic Review of the Literature. Clin Interv Aging. 2023 Feb 18;18:249-261. doi: 10.2147/CIA.S388160. PMID: 36843633; PMCID: PMC9946013.
Rockwood K, Theou O. Using the Clinical Frailty Scale in Allocating Scarce Health Care Resources. Can Geriatr J. 2020 Sep 1;23(3):210-215. doi: 10.5770/cgj.23.463. PMID: 32904824; PMCID: PMC7458601.
Haapanen MJ, Perälä MM, Salonen MK, Kajantie E, Simonen M, Pohjolainen P, Eriksson JG, von Bonsdorff MB. Early life determinants of frailty in old age: the Helsinki Birth Cohort Study. Age Ageing. 2018 Jul 1;47(4):569-575. doi: 10.1093/ageing/afy052. PMID: 29659671.
Karunananthan S, Bergman H. Managing frailty in primary care: evidence gaps cannot be ignored. CMAJ. 2018 Sep 24;190(38):E1122-E1123. doi: 10.1503/cmaj.181151. PMID: 30249757; PMCID: PMC6157488.
Somagutta MR, Uday U, Bathula NR, Pendyala S, Mahadevaiah A, Jain MS, Mahmutaj G, Gad M, Jean Baptiste J. Diagnosing Frailty in Primary Care Practice. Cureus. 2022 Mar 19;14(3):e23329. doi: 10.7759/cureus.23329. PMID: 35464517; PMCID: PMC9015073.
Sablerolles RSG, Lafeber M, van Kempen JAL, van de Loo BPA, Boersma E, Rietdijk WJR, Polinder-Bos HA, Mooijaart SP, van der Kuy H, Versmissen J, Faes MC; COMET research team. Association between Clinical Frailty Scale score and hospital mortality in adult patients with COVID-19 (COMET): an international, multicentre, retrospective, observational cohort study. Lancet Healthy Longev. 2021 Mar;2(3):e163-e170. doi: 10.1016/S2666-7568(21)00006-4. Epub 2021 Feb 9. PMID: 33655235; PMCID: PMC7906710.
McIsaac DI, Taljaard M, Bryson GL, Beaule PE, Gagne S, Hamilton G, Hladkowicz E, Huang A, Joanisse J, Lavallée LT, Moloo H, Thavorn K, van Walraven C, Yang H, Forster AJ. Comparative assessment of two frailty instruments for risk-stratification in elderly surgical patients: study protocol for a prospective cohort study. BMC Anesthesiol. 2016 Nov 14;16(1):111. doi: 10.1186/s12871-016-0276-0. PMID: 27842511; PMCID: PMC5109639.
Jung HW, Jang IY, Back JY, Park S, Park CM, Han SJ, Lee E. Validity of the Clinical Frailty Scale in Korean older patients at a geriatric clinic. Korean J Intern Med. 2021 Sep;36(5):1242-1250. doi: 10.3904/kjim.2020.652. Epub 2020 Dec 30. PMID: 34503320; PMCID: PMC8435494.
Vrettos I, Voukelatou P, Panayiotou S, Kyvetos A, Kalliakmanis A, Makrilakis K, Sfikakis PP, Niakas D. Validation of the revised 9-scale clinical frailty scale (CFS) in Greek language. BMC Geriatr. 2021 Jun 29;21(1):393. doi: 10.1186/s12877-021-02318-3. PMID: 34187373; PMCID: PMC8243421.
Jung HW, Baek JY, Kwon YH, Jang IY, Kim DY, Kwon HS, Lee SH, Oh HJ, Lee E, Koh Y. At-Point Clinical Frailty Scale as a Universal Risk Tool for Older Inpatients in Acute Hospital: A Cohort Study. Front Med (Lausanne). 2022 Jul 6;9:929555. doi: 10.3389/fmed.2022.929555. PMID: 35879923; PMCID: PMC9307996.
Eliakim-Raz N, Stemmer A, Leibovici-Weisman Y, Ness A, Awwad M, Ghantous N, Erez N, Bareket-Samish A, Levy-Barda A, Ben-Zvi H, Moskovits N, Bar-Haim E, Stemmer SM. Three-month follow-up of durability of response to the third dose of the SARS-CoV-2 BNT162b2 vaccine in adults aged 60 years and older: a prospective cohort study. BMJ Open. 2022 Aug 2;12(8):e061584. doi: 10.1136/bmjopen-2022-061584. PMID: 35918111; PMCID: PMC9350740.
Chou YC, Tsou HH, Chan DD, Wen CJ, Lu FP, Lin KP, Wu MC, Chen YM, Chen JH. Validation of clinical frailty scale in Chinese translation. BMC Geriatr. 2022 Jul 20;22(1):604. doi: 10.1186/s12877-022-03287-x. PMID: 35858829; PMCID: PMC9298166.
Chin M, Kendzerska T, Inoue J, Aw M, Mardiros L, Pease C, Andrew MK, Pakhale S, Forster AJ, Mulpuru S. Comparing the Hospital Frailty Risk Score and the Clinical Frailty Scale Among Older Adults With Chronic Obstructive Pulmonary Disease Exacerbation. JAMA Netw Open. 2023 Feb 1;6(2):e2253692. doi: 10.1001/jamanetworkopen.2022.53692. PMID: 36729458; PMCID: PMC9896302.
Zietlow KE, Wong S, Heflin MT, McDonald SR, Sickeler R, Devinney M, Blitz J, Lagoo-Deenadayalan S, Berger M. Geriatric Preoperative Optimization: A Review. Am J Med. 2022 Jan;135(1):39-48. doi: 10.1016/j.amjmed.2021.07.028. Epub 2021 Aug 18. PMID: 34416164; PMCID: PMC8688225.
Flaatten H, Guidet B, Andersen FH, Artigas A, Cecconi M, Boumendil A, Elhadi M, Fjølner J, Joannidis M, Jung C, Leaver S, Marsh B, Moreno R, Oeyen S, Nalapko Y, Schefold JC, Szczeklik W, Walther S, Watson X, Zafeiridis T, de Lange DW; VIP2 Study Group. Reliability of the Clinical Frailty Scale in very elderly ICU patients: a prospective European study. Ann Intensive Care. 2021 Feb 3;11(1):22. doi: 10.1186/s13613-021-00815-7. PMID: 33534010; PMCID: PMC7856616.
Bruno RR, Wernly B, Bagshaw SM, van den Boogaard M, Darvall JN, De Geer L, de Gopegui Miguelena PR, Heyland DK, Hewitt D, Hope AA, Langlais E, Le Maguet P, Montgomery CL, Papageorgiou D, Seguin P, Geense WW, Silva-Obregón JA, Wolff G, Polzin A, Dannenberg L, Kelm M, Flaatten H, Beil M, Franz M, Sviri S, Leaver S, Guidet B, Boumendil A, Jung C. The Clinical Frailty Scale for mortality prediction of old acutely admitted intensive care patients: a meta-analysis of individual patient-level data. Ann Intensive Care. 2023 May 3;13(1):37. doi: 10.1186/s13613-023-01132-x. PMID: 37133796; PMCID: PMC10155148.
Wernly B, Bruno RR, Beil M, Flaatten H, Kelm M, Sigal S, Szczeklik W, Elhadi M, Joannidis M, Koköfer A, Oeyen S, Marsh B, Moreno R, Wernly S, Leaver S, De Lange DW, Guidet B, Jung C. Frailty's influence on 30-day mortality in old critically ill ICU patients: a bayesian analysis evaluating the clinical frailty scale. Ann Intensive Care. 2023 Dec 13;13(1):126. doi: 10.1186/s13613-023-01223-9. PMID: 38091131; PMCID: PMC10719192.
Bock JO, König HH, Brenner H, Haefeli WE, Quinzler R, Matschinger H, Saum KU, Schöttker B, Heider D. Associations of frailty with health care costs--results of the ESTHER cohort study. BMC Health Serv Res. 2016 Apr 14;16:128. doi: 10.1186/s12913-016-1360-3. PMID: 27074800; PMCID: PMC4831082.
Deore HS, Taranikanti M, Gaur A, Varatharajan S, John NA, Katta R, Taranikanti SS, Umesh M, Ganji V, Medala K. Comprehensive, continuous, and compulsory monitoring of frailty in elderly. J Family Med Prim Care. 2023 Dec;12(12):3194-3199. doi: 10.4103/jfmpc.jfmpc_233_23. Epub 2023 Dec 21. PMID: 38361887; PMCID: PMC10866276.
van Oppen JD, Conroy SP, Coats TJ, Mackintosh NJ, Valderas JM. Measuring health-related quality of life of older people with frailty receiving acute care: feasibility and psychometric performance of the EuroQol EQ-5D. BMC Emerg Med. 2023 Nov 19;23(1):137. doi: 10.1186/s12873-023-00909-4. PMID: 37981703; PMCID: PMC10659073.
Mizuguchi Y, Nakao M, Nagai T, Takahashi Y, Abe T, Kakinoki S, Imagawa S, Matsutani K, Saito T, Takahashi M, Kato Y, Komoriyama H, Hagiwara H, Hirata K, Ogawa T, Shimizu T, Otsu M, Chiyo K, Anzai T. Machine learning-based gait analysis to predict clinical frailty scale in elderly patients with heart failure. Eur Heart J Digit Health. 2023 Dec 20;5(2):152-162. doi: 10.1093/ehjdh/ztad082. PMID: 38505484; PMCID: PMC10944685.
Ambagtsheer RC, Shafiabady N, Dent E, Seiboth C, Beilby J. The application of artificial intelligence (AI) techniques to identify frailty within a residential aged care administrative data set. Int J Med Inform. 2020 Apr;136:104094. doi: 10.1016/j.ijmedinf.2020.104094. Epub 2020 Feb 4. PMID: 32058264.
Lee H, Choi JY, Kim SW, Ko KP, Park YS, Kim KJ, Shin J, Kim CO, Ko MJ, Kang SJ, Kim KI. Digital Health Technology Use Among Older Adults: Exploring the Impact of Frailty on Utilization, Purpose, and Satisfaction in Korea. J Korean Med Sci. 2024 Jan 8;39(1):e7. doi: 10.3346/jkms.2024.39.e7. PMID: 38193326; PMCID: PMC10782036.
Hobensack M, Song J, Scharp D, Bowles KH, Topaz M. Machine learning applied to electronic health record data in home healthcare: A scoping review. Int J Med Inform. 2023 Feb;170:104978. doi: 10.1016/j.ijmedinf.2022.104978. Epub 2022 Dec 30. PMID: 36592572; PMCID: PMC9869861.
Breton M, Smithman MA, Liddy C, Keely E, Farrell G, Singer A, Lamoureux-Lamarche C, Dumas Pilon M, Nabelsi V, Gaboury I, Gagnon MP, Steele Gray C, Shaw J, Hudon C, Aubrey-Bassler K, Gagnon J, Côté-Boileau É, Bush PL. Scaling up eConsult for access to specialists in primary healthcare across four Canadian provinces: study protocol of a multiple case study. Health Res Policy Syst. 2019 Sep 12;17(1):83. doi: 10.1186/s12961-019-0483-5. PMID: 31511008; PMCID: PMC6739985.
Checa-López M, Oviedo-Briones M, Pardo-Gómez A, Gonzales-Turín J, Guevara-Guevara T, Carnicero JA, Alamo-Ascencio S, Landi F, Cesari M, Grodzicki T, Rodriguez-Mañas L; FRAILTOOLS consortium. FRAILTOOLS study protocol: a comprehensive validation of frailty assessment tools to screen and diagnose frailty in different clinical and social settings and to provide instruments for integrated care in older adults. BMC Geriatr. 2019 Mar 18;19(1):86. doi: 10.1186/s12877-019-1042-1. PMID: 30885132; PMCID: PMC6423863.
Rosenberg T, Montgomery P, Hay V, Lattimer R. Using frailty and quality of life measures in clinical care of the elderly in Canada to predict death, nursing home transfer and hospitalisation - the frailty and ageing cohort study. BMJ Open. 2019 Nov 12;9(11):e032712. doi: 10.1136/bmjopen-2019-032712. PMID: 31722953; PMCID: PMC6858169.
Carter C, Mohammed S, Upshur R, Kontos P. "I don't see the whole picture of their health": a critical ethnography of constraints to interprofessional collaboration in end-of-life conversations in primary care. BMC Prim Care. 2023 Oct 28;24(1):225. doi: 10.1186/s12875-023-02171-w. PMID: 37898764; PMCID: PMC10612350.
Tyler Williamson P, Aponte-Hao S, Mele B, Lethebe BC, Leduc C, Thandi M, Katz A, Wong ST. Developing and Validating a Primary Care EMR-based Frailty Definition using Machine Learning. Int J Popul Data Sci. 2020 Sep 1;5(1):1344. doi: 10.23889/ijpds.v5i1.1344. PMID: 32935059; PMCID: PMC7477778.
Fanaki C, Fortin J, Sirois MJ, Kröger E, Elliott J, Stolee P, Gregg S, Sims-Gould J, Giguere A. Potential Factors Influencing Adoption of a Primary Care Pathway to Prevent Functional Decline in Older Adults. Can Geriatr J. 2023 Jun 1;26(2):227-238. doi: 10.5770/cgj.26.646. PMID: 37265986; PMCID: PMC10198677.
Ringer T, Thompson C, McLeod S, Melady D. Inter-rater Agreement Between Self-rated and Staff-rated Clinical Frailty Scale Scores in Older Emergency Department Patients: A Prospective Observational Study. Acad Emerg Med. 2020 May;27(5):419-422. doi: 10.1111/acem.13907. Epub 2020 Jan 9. PMID: 31845432.
Leblanc A, Diab N, Backman C, Huang S, Pulfer T, Chin M, Kobewka DM, McIsaac DI, Lawson J, Forster AJ, Mulpuru S. Development and assessment of an educational intervention to improve the recognition of frailty on an acute care respiratory ward. BMJ Open Qual. 2022 Aug;11(3):e001935. doi: 10.1136/bmjoq-2022-001935. PMID: 36454710; PMCID: PMC9362820.
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