ArticleBMC geriatrics2021
How frail is frail? A systematic scoping review and synthesis of high impact studies.
Article in BMC geriatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
43 citing papers in PubMed.
- Goals of Frail Older People Living With Chronic Kidney Disease: A Mixed Methods Study.Journal of the American Geriatrics Society · 2025Trial
- Regional Variation in the Prevalence of Frailty Among Very Old Adults in Germany: Findings of the Nationwide Study "Old Age in Germany" (D80+).Deutsches Arzteblatt international · 2026Observational
- High frailty index scores predict mortality and changes in blood-based biomarkers in aging female mice.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Article
- Frailty among older adults in Germany: regional variation across NAKO study centers.International journal for equity in health · 2026Article
- Association between dietary protein intake and frailty index among home-dwelling older adults; an 8-year follow-up study.The journal of nutrition, health & aging · 2026Article
- Associations between cognitive frailty and circulating cardiovascular biomarkers in a memory clinic cohort.GeroScience · 2026Article
- Regional and Socioeconomic Disparities in Frailty Across Tasmania: Evidence From Island Study Linking Ageing and Neurodegenerative Disease.Australasian journal on ageing · 2026Article
- Variability in Post-Discharge Mortality Rates and Predictors over Time: Data from a Five-Year Ward-Wide Study.Journal of clinical medicine · 2026Article
- Dietary inflammatory index (DII) and attention deficit hyperactivity disorder: a cross-sectional study in US children and adolescents and Mendelian randomization study.European journal of medical research · 2026Article
- Clinical validation of a frailty management mHealth tool in a cohort of community-dwelling older adults: the Geras Fit-Frailty App.BMJ open · 2025Article
- Neighborhood Socioeconomic Disadvantage and Frailty among Mid-to-Older-Aged Adults in Australia: Cross-Sectional and Longitudinal Associations.Journal of urban health : bulletin of the New York Academy of Medicine · 2025Article
- Frailty and hospital outcomes among patients with neurological disorders.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Unraveling the link between frailty and Alzheimer's disease biomarkers in patients with mild cognitive impairment.GeroScience · 2025Article
- Applying a life course approach to elucidate the biology of sex differences in frailty: early-life gonadectomy diminishes late-life robustness in male and female dogs in the Exceptional Aging in Rottweilers Study.Biology of sex differences · 2025Article
- Determining frailty index thresholds for older people across multiple countries in sub-Saharan Africa.Communications medicine · 2025Article
- Outcomes of a pilot feasibility study of comprehensive geriatric assessment for younger frail patients with severe mental illness.BMC psychiatry · 2025Article
- Frailty and associated healthcare expenditures among patients undergoing total hip and knee arthroplasty.The Journal of frailty & aging · 2025Article
- Frailty in motion: Amnestic mild cognitive impairment and Alzheimer's disease cohorts display heterogeneity in multimorbidity classification and longitudinal transitions.Journal of Alzheimer's disease : JAD · 2025Article
- The longitudinal relationship between night-time sleep duration, midday napping, and frailty among middle-aged and older people in China: a prospective analysis.Journal of global health · 2025Article
- Scaling up frailty: psychometric validation of the functional limitations and geriatric syndromes frailty questionnaire-a new tool for uniformly classifying vulnerable hospital patients.Frontiers in medicine · 2025Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsWhile the frailty index (FI) is a continuous variable, an FI score of 0.25 has construct and predictive validity to categorise community-dwelling older adults as frail or non-frail. Our study aimed to explore which FI categories (FI scores and labels) were being used in high impact studies of adults across different care settings and why these categories were being chosen by study authors.
methodsFor this systematic scoping review, Medline, Cochrane and EMBASE databases were searched for studies that measured and categorised an FI. Of 1314 articles screened, 303 met the eligibility criteria (community: N = 205; residential aged care: N = 24; acute care: N = 74). For each setting, the 10 studies with the highest field-weighted citation impact (FWCI) were identified and data, including FI scores and labels and justification provided, were extracted and analysed.
resultsFI scores used to distinguish frail and non-frail participants varied from 0.12 to 0.45 with 0.21 and 0.25 used most frequently. Additional categories such as mildly, moderately and severely frail were defined inconsistently. The rationale for selecting particular FI scores and labels were reported in most studies, but were not always relevant.
conclusionsHigh impact studies vary in the way they categorise the FI and while there is some evidence in the community-dweller literature, FI categories have not been well validated in acute and residential aged care. For the time being, in those settings, the FI should be reported as a continuous variable wherever possible. It is important to continue working towards defining frailty categories as variability in FI categorisation impacts the ability to synthesise results and to translate findings into clinical practice.
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Registered trials
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