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BMC Geriatrics
Published in: BMC Geriatrics 1/2014

Open Access 01-12-2014 | Research article

Screening for frailty in primary care: a systematic review of the psychometric properties of the frailty index in community-dwelling older people

Authors: Irene Drubbel, Mattijs E Numans, Guido Kranenburg, Nienke Bleijenberg, Niek J de Wit, Marieke J Schuurmans

Published in: BMC Geriatrics | Issue 1/2014

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Abstract

Background

To better accommodate for the complex care needs of frail, older people, general practitioners must be capable of easily identifying frailty in daily clinical practice, for example, by using the frailty index (FI). To explore whether the FI is a valid and adequate screening instrument for primary care, we conducted a systematic review of its psychometric properties.

Methods

We searched the Cochrane, PubMed and Embase databases and included original studies focusing on the criterion validity, construct validity and responsiveness of the FI when applied in community-dwelling older people. We evaluated the quality of the studies included using the Quality in Prognosis Studies (QUIPS) tool. This systematic review was conducted based on the PRISMA statement.

Results

Of the twenty studies identified, eighteen reported on FIs derived from research data, one reported upon an FI derived from an administrative database of home-care clients, and one reported upon an FI derived from routine primary care data. In general, the FI showed good criterion and construct validity but lacked studies on responsiveness. When compared with studies that used data gathered for research purposes, there are indications that the FI mean score and range might be different in datasets using routine primary care data; however, this finding needs further investigation.

Conclusions

Our results suggest that the FI is a valid frailty screening instrument. However, further research using routine Electronic Medical Record data is necessary to investigate whether the psychometric properties of the FI are generalizable to a primary care setting and to facilitate its interpretation and implementation in daily clinical practice.

Trial registration

PROSPERO systematic review register number: CRD42013003737.
Appendix
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Metadata
Title
Screening for frailty in primary care: a systematic review of the psychometric properties of the frailty index in community-dwelling older people
Authors
Irene Drubbel
Mattijs E Numans
Guido Kranenburg
Nienke Bleijenberg
Niek J de Wit
Marieke J Schuurmans
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2014
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/1471-2318-14-27

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