Evidence map›Paper›PMID 39889374›Full record

SynthesisThe journal of nutrition, health & aging2025

Comparative analysis of frailty identification tools in community services across the Asia-Pacific: A systematic review and meta-analysis.

Yi-Chen Wu, Chia-Te Chen, Shu-Fen Shen, Liang-Kung Chen, Li-Ning Peng, Heng-Hsin Tung

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The journal of nutrition, health & aging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Observational
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Yi-Chen WuCollege of Nursing and Health Sciences, Da-Yeh University, No.168, University Rd., Dacun, Changhua 515006, Taiwan. Electronic address: yichenwu@mai.dyu.edu.tw.
Chia-Te ChenGraduate Institute of Clinical Nursing, College of Medicine, National Chung Hsing University, No. 145 Xingda Rd., South Dist., Taichung City 402202, Taiwan; Department of Nursing, College of Medicine, National Cheng Kung University, No.1-3, Daxue Rd., East Dist., Tainan City 70101, Taiwan. Electronic address: a0911395524@dragon.nchu.edu.tw.
Shu-Fen ShenDepartment of Nursing, Mackay Medical College, No.46, Sec. 3, Zhongzheng Rd., Sanzhi Dist., New Taipei City 252, Taiwan. Electronic address: shufen@mmc.edu.tw.
Liang-Kung ChenCenter for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan. No.201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 11217, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, No. 155, Sec.2, Linong Street, Beitou Dist., Taipei, 112, Taiwan; Taipei Municipal Gan-Dau Hospital, No. 12, Ln. 225, Zhixing Rd., Beitou Dist., Taipei 112020, Taiwan. Electronic address: lkchen2@vghtpe.gov.tw.
Li-Ning PengCenter for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan. No.201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 11217, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, No. 155, Sec.2, Linong Street, Beitou Dist., Taipei, 112, Taiwan. Electronic address: lining.peng@gmail.com.
Heng-Hsin TungCollege of Nursing, National Yang Ming Chiao Tung University, No. 155, Sec.2, Linong Street, Beitou Dist., Taipei, 112, Taiwan; Tungs' Taichung MetroHarbor Hospital, Taiwan, No.699, Section 8, Taiwan Boulevard, Wuqi District, Taichung City 435403, Taiwan. Electronic address: shannontung719@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis study aimed to compare various frailty screening and assessment tools with the Frailty Phenotype (FP), Frailty Index (FI), and Comprehensive Geriatric Assessment (CGA), which are considered the current gold standards, among the Asia-Pacific population in community settings.

designSystematic review and meta-analysis. SETTING AND

participantsThis review included studies evaluating frailty identification tools based on the criteria of population, index and reference tests, and diagnosis of interest.

methodsA diagnostic test accuracy review was conducted to assess frailty instruments recommended by the Asia-Pacific Clinical Practice Guidelines. Comprehensive electronic database searches and manual searches were conducted up to August 20, 2024. Study quality, including risks of bias and applicability, was assessed using the QUADAS-2 tool. Hierarchical analysis and Youden's index were employed to identify the optimal tool and cutoff points, and pooled frailty prevalence was calculated.

resultsFourteen studies were included: 10 for the FRAIL scale, 3 for TUG, and 2 for the SOF index (screening tools), and 2 each for the CFS and KCL, and 1 for the REFS (assessment tools). All studies demonstrated a high risk of bias. The pooled sensitivity and specificity for screening tools were 0.63 and 0.89, respectively, whereas for assessment tools, they were 0.79 and 0.85. The pooled prevalence of frailty and pre-frailty was 19.7% and 31.7%, respectively. The pooled diagnostic odds ratios were highest for the FRAIL scale (15.72) and CFS (35.03) among the screening and assessment tools. The subgroup analysis revealed that the setting had no significant impact on screening tool performance (p = 0.58), but a borderline significant effect was observed for assessment tools (p = 0.06), although this result is limited by the small number of studies, with only one conducted in a community setting. The FRAIL scale, with a cutoff of 2, had a Youden's index of 0.60, signifying optimal screening performance.

conclusionAmong the frailty instruments recommended by the Asia-Pacific Clinical Practice Guidelines, this meta-analysis identifies the FRAIL scale as the most robust tool for distinguishing frailty, with a cutoff of 2 significantly enhancing diagnostic accuracy. Furthermore, the estimated prevalence of frailty in the Asia-Pacific region is 19.7% across various community settings, underscoring the need for further research and the development of validated assessment tools tailored to this population.

Indexed as

Community Health ServicesFrail ElderlyFrailtyGeriatric AssessmentMass ScreeningAgedAged, 80 and overAsiaHumansPrevalenceSensitivity and SpecificityDiagnostic test accuracyFrailty identificationInstrumentMultiple testsMultiple thresholds

Identifiers

PMID39889374
PMCPMC12180014

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.