Validity & Reliability of the EFS
The Edmonton Frail Scale was validated in 158 individuals seen in in geriatric consultation in both inpatient and outpatient settings (2). In comparison to the impression of frailty by a specialist in Geriatric Medicine, the EFS administered by a non-clinician demonstrated a strong and independent association. The inter-rater reliability was also high at 0.77, and internal consistency was good at 0.62. Construct validity was also established in comparison to the Barthel Index (3).
Since then, the validity, acceptibility and utility of the EFS have been tested in other selected populations, and it has been compared with other frailty measures. Please see “Research to Date” for these details, where there is also information about EFS multi-dimensionality and modifications. Several cross-sectional and longitudinal cohort studies have also used the EFS to better estimate frailty as a risk factor in a wide range of populations.
Research to date:
The following list compiles publications that cite the Edmonton Frail Scale, organized by study type and topic:
(Last updated in July 2023)
Validity, acceptability and utility of the Edmonton Frail Scale in selected populations
Hospitalized population referred for Geriatric Assessment in Canada [1]
Acutely ill inpatient in Australia [2, 3]
Colorectal cancer patients and chemotherapy in Canada [4]
Community dwellers in Colombia [5]
Community-dwellers in Turkey [6]
Systemic Sclerosis patients in Brazil [7]
Rural primary care in Australia [8]
EFS predicts early hospital readmissions in USA [9]
Predictive validity of the EFS for post-op LOS and 12-mo readmissions [10]
Validity, feasibility and reliability of the EFS in post-op patients in Asia [11]
Predicting adverse orthopedic surgery outcomes in Thailand [12]
Older adults with foot disabilities in Spain [13]
Pre-operative prediction of loss of independence in USA [14]
Pre-operative assessment in Canada [15]
Post-operative intervention in Cardiac Surgery in Canada [16]
Preoperative setting in Portugal [17]
Ultrasound quadriceps muscle thickness in hemodialysis patients in England [18]
Persian version of the EFS in Iranian heart failure patients [19]
Portuguese EFS in cardiac surgery in Portugal [20]
Frail prostate cancer patients have similar benefits in QoL and physical function [21]
Comparison with other frailty measures
Systematic reviews comparing frailty measures [22-30]
Neurocognitive Speed in England [31]
Critical Illness, Cardiology and Cardiac Surgery [32]
Implementation of Frailty Measures in Canada [33]
Correlation with the Clinical Frailty Scale in critical illness [34] and perioperative care [35]
Comparison with the Laboratory Frailty Index (LFI ) in end stage renal disease [36]
Chronic Heart Failure in United Kingdom [37]
Hospitalized patient in China [38]
Primary Care population in South Australia [39]
Prognosis in acute coronary syndrome [40]
Meta-analysis of 5 scales showed EFS and complications [41]
7 measures compared DTA and feasibility in general practice setting [42]
EFS and RAI-M compared to Frailty Index in pre-operative context [43]
Frailty Index derived from EFS and CFS in Australia [44]
EFS vs Fried compared in TAVR surgery in Argentina [45]
EFS, Robinson Frailty Score and G8 in predicting postop Adverse Events [46]
Comparison with the Clinical Functional Vulnerability Index-20 [47]
Moderate correlation with a multi-domain frailty index in Australia [48]
Correlation with the Spanish Kihon Checklist [49]
Systematic review of most useful and used measure in surgery [50]
CGA, Fried Index and EFS have similar predictive value in mortality [51]
Mean Platelet Volume/Lymphocyte Ratio in diabetics [52]
Comparison of frailty measures in HD patients in the UK [53]
EFS and CFS in pre-op vascular surgery population in the UK [54]
Resilience and frailty in Internal Medicine inpatients in Italy [55]
Handgrip, mFI and EFS in presurgical ENT population in Nebraska [56]
Prediction of unscheduled rehospitalization in ACS in Poland [57]
Clinical Utility compared to six frailty measures by Australian GPs [58]
Prognosis in heart failure [59]
Prediction of adverse outcomes in diabetic patients in Turkey [60]
Hospitalized patients with malnutrition [61]
Systematic review of frailty and polypharmacy [62]
Validity in relation to the Tilburg Frailty Indicator [63]
Comparison of 6 measures in heart failure [59]
Crosswalk comparisons of commonly used scales [64]
EFS and Fried model compared in COPD exacerbation [65]
Multidimensionality of the EFS
Amnestic Mild Cognitive Impairment in Brazil [66]
Hospitalized adults in Italy [67]
Socially vulnerable adults in Sao Paulo, Brazil [68]
Reducing frailty components in dementia patients through exercise [69]
Brain volumetry and relaxometry signatures frailty domains [70]
Domains of frailty to predict loss of independence after surgery [71]
Modifications of the EFS
Modification of the Functional Performance score [2]
Modification of the cognition score [72]
Kyoto Frailty Scale in Japanese community dwellers [73]
Self-reported EFS in perioperative patient [74]
Prognostic and longitudinal studies using the Edmonton Frail Scale
Postoperative complications in non-cardiac surgery in Canada [75]
Acute coronary syndromes in Canada [76]
All-cause mortality in acute coronary syndrome in France [77]
Serious toxicities after radiotherapy in Ireland [78]
Postoperative outcomes after cardiac surgery in Romania [79]
Post-operative complications after major urologic procedures in Italy [80]
30 day mortality in cardiac surgery in Belgium [81]
Community dwellers in Brazil [82]
Diabetes and chronic kidney disease in Edmonton, Alberta [83]
Cognitive Decline in rural Ecuador [84]
Hospital stay and readmissions in cardiac surgery in New Zealand [10]
Mortality or disability in Peripheral arterial disease in Canada [85]
Hospitalized adults in Vietnam [86, 87]
Hemodialysis patients in Spain [88]
Preop frailty scoring to predict early physical activity post cardiac surgery [89]
‘Being Your Best’ protocol to reduce frailty symptoms in Australia [90]
Frailty associated with higher postoperative opioid use in Australia [91]
Association with BMI in hospitalized patients in USA [92]
Frailty associated with fatigue in cancer patients in Turkey [93]
Preoperative frailty and outcomes after cardiac surgery [94]
Factors that predict frailty state transitions in Brazil [95]
Factors associated with frailty in a New Zealand HD population [96]
Factors associated with frailty in a Brazilian longitudinal study [97]
Cardiac Rehabilitation to improve gait speed in frail patients [98]
Exercise reduced EFS scores after 3 months in nursing home in Turkey [99]
Physical Exercise and Cognitive training in frail HD patients in Slovenia [100]
Wearable kinematic measures and frailty trajectories in Cardiac Rehab [101]
Outcomes after Acute Coronary Syndrome in Poland [57]
Olfactory Dysfunction and Surgical Outcomes in Belgium [102]
Incident Cerebral microbleeds in Community dwellers in Ecuador [103]
Chemotherapy Toxicity in Turkey [104]
Hemodialysis patient in England [105]
Postoperative walking intervention and recovery in USA [106]
Postoperative Delirium in USA [107]
Radiation Oncology patients in Norway [108]
Hemodialysis patients with cognitive impairment in England [109]
EFS doesn’t predict chemotherapy toxicity but useful for CGA [104]
Higher frailty influences fear of falling in Turkey [110]
Preoperative walking did not improve post-op recovery in frailty [106]
Preoperative CGA and optimization in elective noncardiac surgery [111]
EFS predicts mortality in radiotherapy in Norway [108]
Self-managed exercise-nutrition program benefits frailty in hospital [112]
Cross-sectional studies on frailty using the EFS in selected populations
Hospitalized adults in Italy [67]
Community dwellers with or without diabetes or foot ulcers in Brazil [113]
Dementia in Portugal [114, 115]
Geriatric Referral population in Brazil [116]
Amnestic Mild Cognitive Impairment in Brazil [66]
Community dwellers in Brazil [117-119]
Social vulnerability and cognitive performance in Brazil [120]
Men living with HIV in Australia [121]
Association with caregiver burden in Turkey [122]
Association with Polypharmacy [123]
Community dwellers in China [124]
Hematological malignancies in Turkey [125]
Hospitalized adults in New Zealand [126]
Acute Coronary Syndrome population in Vietnam [127]
Inflammatory markers in Cardiac Surgery patients in Central Europe [128]
Oral health and Frailty in Australian inpatients [129]
DOACs safe even in frail adults [130]
Hospital admissions over holidays have higher frailty scores [131]
A Fib predicts frailer community dwellers in Taiwan [132]
Frailty not associated with falls in remote rural Ecuador [133]
Frailty worsens QoL and risk of arrhythmia in Poland [134]
Gustatory dysfunction as a risk for frailty in CKD [135]
Frailty and Elder abuse in Brazil [136, 137]
No association between frailty and antihypertensive adherence [138]
Pre-op frailty and post-op outcomes in colorectal cancer surgery [139]
Impaired QoL and comorbidities in Coronary Artery Disease in UK [140]
Baseline frailty predicts post-op cognitive impairment in Australia [141]
Malnutrition risk, frailty and physical disability in care homes in UK [142]
Frailty and A Fibrillation increase risk for mood disorders [143]
No association with delirium in a meta-analysis [144]
Frailty vs Sarcopenia in hospitalized patients in Saudi Arabia [145]
Frailty vs Sarcopenia in predicting adverse post-op outcomes [146]
Frailty associations in community dwellers in Cyprus [147]
Pain and depression in cirrhosis in USA [148]
Foot pain and degrees of frailty [149]
Multimorbidity and frailty in a surgical population in Singapore [150]
High risk of malnutrition predicts frailty [151]
Hospitalized inpatients in Turkey [152]
Community dwellers in periurban slums of Dehli, India [153]
Prevalence and prognosis of frailty in Cardiac ICUs in France [154]
Frailty and malnutrition in older hospitalized patients in Australia [155]
Frailty in Primary Care in Brazil [156]
Frailty and mortality in a rural community in India [157]
Sociodemographic factors associated with frailty in Brazil [97]
Higher Hgb A1C correlates with frailty by EFS in two studies [158]
Frailty and Inflammatory Markers in home dwellers in Turkey [159]
Frailty and white matter changes in community dwellers in Ecuador [160]
Anticholinergic Load and Frailty in Geriatric inpatients in Australia [161]
Neurodegenerative diseases and frailty in Brazilian outpatients [162]
Digital Literacy in Italy [163]
Cancer patients in Turkey [164]
Fear of Falling Avoidance Behaviour in Turkey [110]
Pre-operative CGA in England [111]
Walking speed in older community dwellers in Vietnam [165]
Preoperative Assessment (FIT-65) in England [166]
Inappropriate Medication use in a surgical population [167]
Kidney Transplant patients in England [167]
Heart Failure patients in Poland [168]
Traumatic Brain Injury recovery in Belgium [169]
Pain in hospitalized patients in Australia [170]
Hospitalized patients in Turkey [171]
EFS and FRAIL in hospitalized older persons [171]
Systematic review of frailty and anticoagulation [172]
References
REFERENCES
1. Rolfson, D.B., et al., Validity and reliability of the Edmonton Frail Scale. Age Ageing, 2006. 35(5): p. 526-9.
2. Hilmer, S.N., et al., The assessment of frailty in older people in acute care. Australas J Ageing, 2009. 28(4): p. 182-8.
3. Rose, M., et al., Can frailty predict complicated care needs and length of stay? Intern Med J, 2014. 44(8): p. 800-5.
4. Meyers, B.M., et al., Utility of the Edmonton Frail Scale in identifying frail elderly patients during treatment of colorectal cancer. J Gastrointest Oncol, 2017. 8(1): p. 32-38.
5. Ramirez Ramirez, J.U., M.O. Cadena Sanabria, and M.E. Ochoa, [Edmonton Frail Scale in Colombian older people. Comparison with the Fried criteria]. Rev Esp Geriatr Gerontol, 2017. 52(6): p. 322-325.
6. Aygor, H.E., et al., VALIDATION OF EDMONTON FRAIL SCALE INTO ELDERLY TURKISH POPULATION. Arch Gerontol Geriatr, 2018. 76: p. 133-137.
7. Brundle, C., et al., Convergent validity of the electronic frailty index. Age Ageing, 2018.
8. Abernethy, G., et al., Investigation on the use and acceptability of the Edmonton Frail Scale in a rural primary care setting. Aust J Rural Health, 2018. 26(6): p. 449-450.
9. Stillman, G.R., A.N. Stillman, and M.S. Beecher, Frailty Is Associated With Early Hospital Readmission in Older Medical Patients. J Appl Gerontol, 2021. 40(1): p. 38-46.
10. Lal, S., et al., Frailty in Elderly Patients Undergoing Cardiac Surgery Increases Hospital Stay and 12-Month Readmission Rate. Heart Lung Circ, 2019.
11. He, Y., et al., Assessment of predictive validity and feasibility of Edmonton Frail Scale in identifying postoperative complications among elderly patients: a prospective observational study. Sci Rep, 2020. 10(1): p. 14682.
12. Roopsawang, I., et al., Predicting hospital outcomes with the reported edmonton frail scale-Thai version in orthopaedic older patients. J Clin Nurs, 2020. 29(23-24): p. 4708-4719.
13. Navarro-Flores, E., et al., The reliability, validity, and sensitivity of the Edmonton Frail Scale (EFS) in older adults with foot disorders. Aging (Albany NY), 2020. 12(24): p. 24623-24632.
14. Owodunni, O.P., et al., Preoperative Frailty Assessment, Operative Severity Score, and Early Postoperative Loss of Independence in Surgical Patients Age 65 Years or Older. J Am Coll Surg, 2021. 232(4): p. 387-395.
15. Bautista, L., et al., The Edmonton Frail Scale as a preoperative assessment tool in elective outpatient surgery. Can J Anaesth, 2021. 68(6): p. 925-927.
16. Sarkar, S., et al., Enhanced Telehealth Home-Monitoring Intervention for Vulnerable and Frail Patients after Cardiac Surgery (THE-FACS Pilot Intervention Study). BMC Geriatr, 2022. 22(1): p. 836.
17. Castro, M.L., et al., Reproducibility and validity of the Portuguese Edmonton Frail Scale version in cardiac surgery patients. Rev Port Cardiol, 2023.
18. Anderson, B.M., et al., Ultrasound quadriceps muscle thickness is variably associated with frailty in haemodialysis recipients. BMC Nephrol, 2023. 24(1): p. 16.
19. Alaei, H., et al., Translation, cultural adaptation, validation and reliability of Persian version of Edmonton frailty score questionnaire among Iranian heart failure individuals. Caspian J Intern Med, 2023. 14(1): p. 53-59.
20. Castro, M.L., et al., Reproducibility and validity of the Portuguese Edmonton Frail Scale version in cardiac surgery patients. Rev Port Cardiol, 2023. 42(4): p. 295-304.
21. Kim, V.S., et al., The role of frailty in modifying physical function and quality of life over time in older men with metastatic castration-resistant prostate cancer. J Geriatr Oncol, 2023. 14(2): p. 101417.
22. Faller, J.W., et al., Instruments for the detection of frailty syndrome in older adults: A systematic review. PLoS One, 2019. 14(4): p. e0216166.
23. Aguayo, G.A., et al., Agreement Between 35 Published Frailty Scores in the General Population. Am J Epidemiol, 2017. 186(4): p. 420-434.
24. Bouillon, K., et al., Measures of frailty in population-based studies: an overview. BMC Geriatrics, 2013. 13(1): p. 64.
25. Dent, E., P. Kowal, and E.O. Hoogendijk, Frailty measurement in research and clinical practice: A review. Eur J Intern Med, 2016. 31: p. 3-10.
26. Hogan, D.B., et al., Comparing frailty measures in their ability to predict adverse outcome among older residents of assisted living. BMC Geriatrics, 2012. 12(1): p. 56.
27. Sternberg, S.A., et al., The identification of frailty: a systematic literature review. J Am Geriatr Soc, 2011. 59(11): p. 2129-38.
28. Theou, O., et al., Operationalization of frailty using eight commonly used scales and comparison of their ability to predict all-cause mortality. J Am Geriatr Soc, 2013. 61(9): p. 1537-51.
29. Theou, O., et al., Identifying common characteristics of frailty across seven scales. J Am Geriatr Soc, 2014. 62(5): p. 901-6.
30. Hogan, D.B., et al., A Scoping Review of Frailty and Acute Care in Middle-Aged and Older Individuals with Recommendations for Future Research. Can Geriatr J, 2017. 20(1): p. 22-37.
31. Rolfson, D.B., et al., An assessment of neurocognitive speed in relation to frailty. Age Ageing, 2013. 42(2): p. 191-6.
32. Rajabali, N., D. Rolfson, and S.M. Bagshaw, Assessment and Utility of Frailty Measures in Critical Illness, Cardiology, and Cardiac Surgery. Can J Cardiol, 2016. 32(9): p. 1157-65.
33. Rolfson, D.B., et al., Implementing Frailty Measures in the Canadian Healthcare System. J Frailty Aging, 2018. 7(4): p. 208-216.
34. Darvall, J.N., et al., Contributors to frailty in critical illness: Multi-dimensional analysis of the Clinical Frailty Scale. J Crit Care, 2019. 52: p. 193-199.
35. Darvall, J.N., et al., Accuracy of the Clinical Frailty Scale for perioperative frailty screening: a prospective observational study. Can J Anaesth, 2020.
36. Chao, C.T., et al., Applicability of laboratory deficit-based frailty index in predominantly older patients with end-stage renal disease under chronic dialysis: A pilot test of its correlation with survival and self-reported instruments. Nephrology (Carlton), 2019.
37. Sze, S., et al., Identification of Frailty in Chronic Heart Failure. JACC Heart Fail, 2019. 7(4): p. 291-302.
38. Liang, Y.D., et al., Identification of Frailty and Its Risk Factors in Elderly Hospitalized Patients from Different Wards: A Cross-Sectional Study in China. Clin Interv Aging, 2019. 14: p. 2249-2259.
39. Ambagtsheer, R.C., et al., Commonly used screening instruments to identify frailty among community-dwelling older people in a general practice (primary care) setting: a study of diagnostic test accuracy. J Gerontol A Biol Sci Med Sci, 2019.
40. Zhang, S., et al., Is frailty a prognostic factor for adverse outcomes in older patients with acute coronary syndrome? Aging Clin Exp Res, 2019.
41. Aucoin, S.D., et al., Accuracy and Feasibility of Clinically Applied Frailty Instruments before Surgery: A Systematic Review and Meta-analysis. Anesthesiology, 2020. 133(1): p. 78-95.
42. Ambagtsheer, R.C., et al., Feasibility and acceptability of commonly used screening instruments to identify frailty among community-dwelling older people: a mixed methods study. BMC Geriatr, 2020. 20(1): p. 152.
43. Vargas, J., et al., [Assessment of two frailty scales for the preoperative period]. Rev Med Chil, 2020. 148(3): p. 311-319.
44. Darvall, J.N., et al., Development of a Frailty Index from Routine Hospital Data in Perioperative and Critical Care. J Am Geriatr Soc, 2020. 68(12): p. 2831-2838.
45. Romeo, F.J., et al., Measuring frailty in patients with severe aortic stenosis: a comparison of the edmonton frail scale with modified fried frailty assessment in patients undergoing transcatheter aortic valve replacement. J Geriatr Cardiol, 2020. 17(7): p. 441-446.
46. Nishijima, T.F., et al., Preoperative frailty assessment with the Robinson Frailty Score, Edmonton Frail Scale, and G8 and adverse postoperative outcomes in older surgical patients with cancer. Eur J Surg Oncol, 2021. 47(4): p. 896-901.
47. Carneiro, J.A., et al., Frailty in community-dwelling older people: comparing screening instruments. Rev Saude Publica, 2020. 54: p. 119.
48. Lo, S.Y., et al., Development and validation of a frailty index based on data routinely collected across multiple domains in NSW hospitals. Australas J Ageing, 2021. 40(2): p. 184-194.
49. Sentandreu-Mañó, T., et al., Kihon Checklist to assess frailty in older adults: Some evidence on the internal consistency and validity of the Spanish version. Geriatr Gerontol Int, 2021. 21(2): p. 262-267.
50. Gené, C., et al., Preoperative Assessment of Geriatric Surgical Patients: Update on Clinical Scales Used for Elective General and Digestive Surgery. Surg Laparosc Endosc Percutan Tech, 2021. 31(3): p. 368-375.
51. Varan, H.D., et al., Comparative Evaluation of Predictive Ability of Comprehensive Geriatric Assessment Components Including Frailty on Long-Term Mortality. Exp Aging Res, 2021. 47(3): p. 220-231.
52. Bilgin, S., et al., Does mean platelet volume/lymphocyte count ratio associate with frailty in type 2 diabetes mellitus? Bratisl Lek Listy, 2021. 122(2): p. 116-119.
53. Anderson, B.M., et al., Correlations, agreement and utility of frailty instruments in prevalent haemodialysis patients: baseline cohort data from the FITNESS study. Clin Kidney J, 2022. 15(1): p. 145-152.
54. Ayyash, R., et al., Utility and reliability of the Clinical Frailty Scale in patients scheduled for major vascular surgery: a prospective, observational, multicentre observer-blinded study. Perioper Med (Lond), 2022. 11(1): p. 6.
55. Lenti, M.V., et al., Resilience is associated with frailty and older age in hospitalised patients. BMC Geriatr, 2022. 22(1): p. 569.
56. Pandey, Y., et al., Evaluation of Agreement Among Frailty Assessment Tools in Head and Neck Surgery. Otolaryngol Head Neck Surg, 2023. 168(1): p. 32-38.
57. Nowak, W., et al., Comparison of the prognostic value of frailty assessment tools in patients aged ≥ 65 years hospitalized in a cardiac care unit with acute coronary syndrome. J Geriatr Cardiol, 2022. 19(5): p. 343-353.
58. Ambagtsheer, R.C., et al., Practitioner perceptions of the feasibility of common frailty screening instruments within general practice settings: a mixed methods study. BMC Prim Care, 2022. 23(1): p. 160.
59. Sze, S., et al., Which frailty tool best predicts morbidity and mortality in ambulatory patients with heart failure? A prospective study. Eur Heart J Qual Care Clin Outcomes, 2022.
60. Akan, S. and G. Aktas, Relationship between frailty, according to three frail scores, and clinical and laboratory parameters of the geriatric patients with type 2 Diabetes Mellitus. Rev Assoc Med Bras (1992), 2022. 68(8): p. 1073-1077.
61. Sharma, Y., et al., Validity of the Malnutrition Universal Screening Tool for Evaluation of Frailty Status in Older Hospitalised Patients. Gerontol Geriatr Med, 2022. 8: p. 23337214221107817.
62. Toh, J.J.Y., et al., Prevalence and health outcomes of polypharmacy and hyperpolypharmacy in older adults with frailty: A systematic review and meta-analysis. Ageing Res Rev, 2023. 83: p. 101811.
63. Balasch-Bernat, M., et al., Deepening the understanding of the structural validity of the Tilburg Frailty Indicator. Aging Clin Exp Res, 2023.
64. Sison, S.D.M., et al., A crosswalk of commonly used frailty scales. J Am Geriatr Soc, 2023.
65. Morita, A.A., et al., Comparison of Two Frailty Assessment Methods and Their Association with Functionality in Subjects with Exacerbation of COPD. Curr Gerontol Geriatr Res, 2023. 2023: p. 6660984.
66. Cezar, N.O.C., et al., Frailty in older adults with amnestic mild cognitive impairment as a result of Alzheimer's disease: A comparison of two models of frailty characterization. Geriatr Gerontol Int, 2017. 17(11): p. 2096-2102.
67. Perna, S., et al., Performance of Edmonton Frail Scale on frailty assessment: its association with multi-dimensional geriatric conditions assessed with specific screening tools. BMC Geriatr, 2017. 17(1): p. 2.
68. Araujo Junior, F.B., et al., Frailty, profile and cognition of elderly residents in a highly socially vulnerability area. Cien Saude Colet, 2019. 24(8): p. 3047-3056.
69. Cezar, N.O.C., et al., Feasibility of reducing frailty components in older adults with Alzheimer's dementia: a randomized controlled home-based exercise trial (AD-HOMEX). Exp Gerontol, 2021. 150: p. 111390.
70. Li, C., et al., Associations between brain volumetry and relaxometry signatures and the Edmonton Frail Scale in frailty. Quant Imaging Med Surg, 2021. 11(6): p. 2560-2571.
71. Goeddel, L., et al., Domains of Frailty Predict Loss of Independence in Older Adults after Non-Cardiac Surgery. Ann Surg, 2022.
72. Rose, M., et al., Novel modification of the Reported Edmonton Frail Scale. Australas J Ageing, 2018. 37(4): p. 305-308.
73. Kameda, M., R. Shibata, and H. Kondoh, Efficient and rapid assessment of multiple aspects of frailty using the Kyoto Frailty Scale, developed from the Edmonton Frail Scale. J Phys Ther Sci, 2021. 33(3): p. 267-273.
74. Sirisegaram, L., et al., Validation of the self-reported domains of the Edmonton Frail Scale in patients 65 years of age and older. BMC Geriatr, 2023. 23(1): p. 15.
75. Dasgupta, M., et al., Frailty is associated with postoperative complications in older adults with medical problems. Arch Gerontol Geriatr, 2009. 48(1): p. 78-83.
76. Graham, M.M., et al., Frailty and outcome in elderly patients with acute coronary syndrome. Can J Cardiol, 2013. 29(12): p. 1610-5.
77. Blanco, S., et al., Prognosis Impact of Frailty Assessed by the Edmonton Frail Scale in the Setting of Acute Coronary Syndrome in the Elderly. Can J Cardiol, 2017. 33(7): p. 933-939.
78. Keenan, L.G., et al., Assessment of older patients with cancer: Edmonton Frail Scale (EFS) as a predictor of adverse outcomes in older patients undergoing radiotherapy. J Geriatr Oncol, 2017. 8(3): p. 206-210.
79. Kovacs, J., et al., Are frailty scales better than anesthesia or surgical scales to determine risk in cardiac surgery? Korean J Anesthesiol, 2017. 70(2): p. 157-162.
80. Moro, F.D., et al., Frailty and elderly in urology: Is there an impact on post-operative complications? Cent European J Urol, 2017. 70(2): p. 197-205.
81. Amabili, P., et al., The Edmonton Frail Scale Improves the Prediction of 30-Day Mortality in Elderly Patients Undergoing Cardiac Surgery: A Prospective Observational Study. J Cardiothorac Vasc Anesth, 2018.
82. Fhon, J.R.S., et al., Factors associated with frailty in older adults: a longitudinal study. Rev Saude Publica, 2018. 52: p. 74.
83. Adame Perez, S.I., et al., Frailty, Health-Related Quality of Life, Cognition, Depression, Vitamin D and Health-Care Utilization in an Ambulatory Adult Population with Type 1 or Type 2 Diabetes Mellitus and Chronic Kidney Disease: A Cross-Sectional Analysis. Can J Diabetes, 2018.
84. Del Brutto, O.H., et al., Influence of Frailty on Cognitive Decline: A Population-Based Cohort Study in Rural Ecuador. J Am Med Dir Assoc, 2019. 20(2): p. 213-216.
85. Drudi, L.M., et al., Frailty assessment in older adults undergoing interventions for peripheral arterial disease. J Vasc Surg, 2019.
86. Vu, H.T.T., et al., Prevalence of frailty and its associated factors in older hospitalised patients in Vietnam. BMC Geriatr, 2017. 17(1): p. 216.
87. Nguyen, A.T., et al., The impact of frailty on prolonged hospitalization and mortality in elderly inpatients in Vietnam: a comparison between the frailty phenotype and the Reported Edmonton Frail Scale. Clin Interv Aging, 2019. 14: p. 381-388.
88. Garcia-Canton, C., et al., Frailty in hemodialysis and prediction of poor short-term outcome: mortality, hospitalization and visits to hospital emergency services. Ren Fail, 2019. 41(1): p. 567-575.
89. Abdullahi, Y.S., et al., The Use of Frailty Scoring to Predict Early Physical Activity Levels After Cardiac Surgery. Ann Thorac Surg, 2021. 111(1): p. 36-43.
90. Lowthian, J.A., et al., Being Your Best: protocol for a feasibility study of a codesigned approach to reduce symptoms of frailty in people aged 65 years or more after transition from hospital. BMJ Open, 2021. 11(3): p. e043223.
91. Auckley, E.D., et al., Frailty status as a potential factor in increased postoperative opioid use in older adults. BMC Geriatr, 2021. 21(1): p. 189.
92. Bhardwaj, P.V., et al., The Association Between Body Mass Index, Frailty and Long-Term Clinical Outcomes in Hospitalized Older Adults. Am J Med Sci, 2021. 362(3): p. 268-275.
93. Uslu, A. and O. Canbolat, Relationship Between Frailty and Fatigue in Older Cancer Patients. Semin Oncol Nurs, 2021. 37(4): p. 151179.
94. Montgomery, C., et al., Association between preoperative frailty and outcomes among adults undergoing cardiac surgery: a prospective cohort study. CMAJ Open, 2021. 9(3): p. E777-e787.
95. de Jesus, I.T.M., et al., Frailty state transitions among non-frail and vulnerable older adults: Does mobility performance really matter? Geriatr Nurs, 2021. 42(6): p. 1367-1372.
96. Bloomfield, K., et al., Frailty prevalence in Aotearoa New Zealand haemodialysis patients and its association with hospitalisations. N Z Med J, 2021. 134(1546): p. 95-108.
97. Fhon, J.R.S., et al., Frailty and sociodemographic and health factors, and social support network in the brazilian elderly: A longitudinal study. Rev Esc Enferm USP, 2021. 56: p. e20210192.
98. Beigienė, A., et al., Frailty and Different Exercise Interventions to Improve Gait Speed in Older Adults after Acute Coronary Syndrome. Medicina (Kaunas), 2021. 57(12).
99. Sahin, S., et al., The Impact of the Otago Exercise Program on Frailty and Empowerment in Older Nursing Home Residents: A Randomized Controlled Trial. Ann Geriatr Med Res, 2022. 26(1): p. 25-32.
100. Bogataj, Š., et al., Effects of Intradialytic Cognitive and Physical Exercise Training on Cognitive and Physical Abilities in Hemodialysis Patients: Study Protocol for a Randomized Controlled Trial. Front Psychol, 2022. 13: p. 835486.
101. Butkuviene, M., et al., Wearable-Based Assessment of Frailty Trajectories During Cardiac Rehabilitation After Open-Heart Surgery. IEEE J Biomed Health Inform, 2022. 26(9): p. 4426-4435.
102. Van Regemorter, V., et al., Olfactory Dysfunction Predicts Frailty and Poor Postoperative Outcome in Older Patients Scheduled for Elective Non-Cardiac Surgery. J Nutr Health Aging, 2022. 26(11): p. 981-986.
103. Del Brutto, O.H., et al., De novo appearance of cerebral microbleeds in community-dwelling older adults. Neuroimaging and clinical correlates. Neuroradiol J, 2022: p. 19714009221141401.
104. Akbıyık, I., et al., Association of frailty with chemotherapy toxicity in chemotherapy-naive older patients with cancer. Support Care Cancer, 2022. 30(12): p. 9975-9981.
105. Anderson, B.M., et al., Self-reported health change in haemodialysis recipients modulates the effect of frailty upon mortality and hospital admissions: outcomes from a large prospective UK cohort. Nephrol Dial Transplant, 2022.
106. Sadiq, H., et al., Preoperative walking intervention did not appear to improve patient-reported postoperative recovery in older adults with frailty traits: Randomized trial. Medicine (Baltimore), 2022. 101(38): p. e30689.
107. Sieber, F., et al., Edmonton frailty scale score predicts postoperative delirium: a retrospective cohort analysis. BMC Geriatr, 2022. 22(1): p. 585.
108. Røyset, I.M., et al., Edmonton Frail Scale predicts mortality in older patients with cancer undergoing radiotherapy-A prospective observational study. PLoS One, 2023. 18(3): p. e0283507.
109. Anderson, B.M., et al., Cognitive Impairment, Frailty, and Adverse Outcomes Among Prevalent Hemodialysis Recipients: Results From a Large Prospective Cohort Study in the United Kingdom. Kidney Med, 2023. 5(4): p. 100613.
110. Öztürk, D. and Z. Özer, The mediator role of frailty in the effect of fear of falling avoidance behavior on quality of life in older adults admitted to hospital. Geriatr Nurs, 2022. 48: p. 132-138.
111. Shahab, R., et al., A Description of Interventions Prompted by Preoperative Comprehensive Geriatric Assessment and Optimization in Older Elective Noncardiac Surgical Patients. J Am Med Dir Assoc, 2022. 23(12): p. 1948-1954.e4.
112. Han, C.Y., et al., Individualized Hospital to Home, Exercise-Nutrition Self-Managed Intervention for Pre-Frail and Frail Hospitalized Older Adults: The INDEPENDENCE Randomized Controlled Pilot Trial. Clin Interv Aging, 2023. 18: p. 809-825.
113. Boas, N., G.M. Salome, and L.M. Ferreira, Frailty syndrome and functional disability among older adults with and without diabetes and foot ulcers. J Wound Care, 2018. 27(7): p. 409-416.
114. Abreu, W., et al., A cross-sectional study of family caregiver burden and psychological distress linked to frailty and functional dependency of a relative with advanced dementia. Dementia (London), 2018: p. 1471301218773842.
115. Abreu, W., et al., The relationship between frailty, functional dependence, and healthcare needs among community-dwelling people with moderate to severe dementia. Health Soc Care Community, 2018.
116. Carneiro, J.A., et al., Frailty in the elderly: prevalence and associated factors. Rev Bras Enferm, 2017. 70(4): p. 747-752.
117. Cruz, D.T.D., et al., Factors associated with frailty in a community-dwelling population of older adults. Rev Saude Publica, 2017. 51: p. 106.
118. Carneiro, J.A., et al., Health care are associated with worsening of frailty in community older adults. Rev Saude Publica, 2019. 53: p. 32.
119. Farias-Antunez, S. and A.G. Fassa, Frailty prevalence and associated factors in the elderly in Southern Brazil, 2014. Epidemiol Serv Saude, 2019. 28(1): p. e2017405.
120. de Jesus, I.T.M., F.S. Orlando, and M.S. Zazzetta, Frailty and cognitive performance of elderly in the context of social vulnerability. Dement Neuropsychol, 2018. 12(2): p. 173-180.
121. Yeoh, H.L., et al., Frailty in men living with HIV: a cross-sectional comparison of three frailty instruments. Antivir Ther, 2018. 23(2): p. 117-127.
122. Gok Metin, Z., et al., The Perceived Caregiver Burden Among Turkish Family Caregivers Providing Care for Frail Older Adults. J Transcult Nurs, 2018: p. 1043659618790041.
123. Gutierrez-Valencia, M., et al., The relationship between frailty and polypharmacy in older people: A systematic review. Br J Clin Pharmacol, 2018. 84(7): p. 1432-1444.
124. Yang, L., et al., Evaluation of frailty status among older people living in urban communities by Edmonton Frail Scale in Wuhu, China: a cross-sectional study. Contemp Nurse, 2018: p. 1-22.
125. Atakul, E. and I. Akyar, Frailty Prevalence and Characteristics in Older Adults with Hematologic Cancer: a Descriptive Study. Asia Pac J Oncol Nurs, 2019. 6(1): p. 43-49.
126. Richards, S.J.G., et al., Prevalence of frailty in a tertiary hospital: A point prevalence observational study. PLoS One, 2019. 14(7): p. e0219083.
127. Nguyen, T.V., et al., Frailty in Older Patients with Acute Coronary Syndrome in Vietnam. Clin Interv Aging, 2019. 14: p. 2213-2222.
128. Kiss, R., et al., Determination of frail state and association of frailty with inflammatory markers among cardiac surgery patients in a Central European patient population. Clin Hemorheol Microcirc, 2019.
129. Shwe, P.S., et al., Frailty, oral health and nutrition in geriatrics inpatients: A cross-sectional study. Gerodontology, 2019. 36(3): p. 223-228.
130. De Simone, V., et al., Direct oral anticoagulants for patients aged over 80 years in nonvalvular atrial fibrillation: the impact of frailty. J Cardiovasc Med (Hagerstown), 2020. 21(8): p. 562-569.
131. Lenti, M.V., et al., Clinical complexity and hospital admissions in the December holiday period. PLoS One, 2020. 15(6): p. e0234112.
132. Yang, M.T., et al., The relationship between atrial fibrillation and frailty in community-dwelling older adults. Arch Gerontol Geriatr, 2020. 90: p. 104103.
133. Del Brutto, O.H., et al., Frailty and Risk of Falls in Community-Dwelling Older Adults Living in a Rural Setting. The Atahualpa Project. J Frailty Aging, 2020. 9(3): p. 150-154.
134. Sławuta, A., et al., Quality of Life and Frailty Syndrome in Patients with Atrial Fibrillation. Clin Interv Aging, 2020. 15: p. 783-795.
135. Chen, S.I., et al., Gustatory Dysfunction Is Closely Associated With Frailty in Patients With Chronic Kidney Disease. J Ren Nutr, 2021. 31(1): p. 49-56.
136. Dos Santos, R.C., et al., Frailty Syndrome: A Risk Factor Associated With Violence in Older Adults. J Forensic Nurs, 2020. 16(3): p. 130-137.
137. Soares, J.D.S., et al., Risk of violence and frailty syndrome among older adults treated at a hospital service. Rev Bras Enferm, 2023. 76Suppl 2(Suppl 2): p. e20220278.
138. Silva, L.M., et al., Treatment adherence and frailty syndrome in hypertensive older adults. Rev Esc Enferm USP, 2020. 54: p. e03590.
139. Richards, S.J.G., et al., Pre-operative frailty is predictive of adverse post-operative outcomes in colorectal cancer patients. ANZ J Surg, 2021. 91(3): p. 379-386.
140. Qayyum, S., et al., Prospective cohort study of elderly patients with coronary artery disease: impact of frailty on quality of life and outcome. Open Heart, 2020. 7(2).
141. Evered, L.A., et al., Preoperative Frailty Predicts Postoperative Neurocognitive Disorders After Total Hip Joint Replacement Surgery. Anesth Analg, 2020. 131(5): p. 1582-1588.
142. Fashho, E., et al., Investigating the prevalence of malnutrition, frailty and physical disability and the association between them amongst older care home residents. Clin Nutr ESPEN, 2020. 40: p. 231-236.
143. Jankowska-Polańska, B., et al., The Role of Sleep Disturbance, Depression and Anxiety in Frail Patients with AF-Gender Differences. J Clin Med, 2020. 10(1).
144. Zhang, X.M., et al., The Association Between Frailty and Delirium Among Hospitalized Patients: An Updated Meta-Analysis. J Am Med Dir Assoc, 2021. 22(3): p. 527-534.
145. Alodhayani, A.A., et al., Frailty, sarcopenia and health related outcomes among elderly patients in Saudi Arabia. Saudi J Biol Sci, 2021. 28(2): p. 1213-1217.
146. Şengül Ayçiçek, G., et al., Impact of frailty and ultrasonography-based sarcopenia on the development of postoperative complications in gastrointestinal cancer patients. Turk J Med Sci, 2021. 51(3): p. 1261-1266.
147. Güngör Başaran, A.Y. and E. Akal Yıldız, Nutrition Status, Muscle Mass, and Frailty in Older People: A Cross-Sectional Study Conducted in Cyprus. J Am Nutr Assoc, 2022. 41(3): p. 318-324.
148. Deng, L.X., et al., Frailty is strongly associated with self-reported symptom burden among patients with cirrhosis. Eur J Gastroenterol Hepatol, 2021. 33(1S Suppl 1): p. e395-e400.
149. Navarro-Flores, E., et al., Influence of foot pain on frailty symptoms in an elderly population: a case-control study. Sao Paulo Med J, 2021. 139(4): p. 319-324.
150. Au Yong, P.S.A., et al., Association of Multimorbidity With Frailty in Older Adults for Elective Non-Cardiac Surgery. Cureus, 2021. 13(5): p. e15033.
151. Sharma, Y., et al., The overlap of frailty and malnutrition in older hospitalised patients: An observational study. Asia Pac J Clin Nutr, 2021. 30(3): p. 457-463.
152. Düzgün, G., S. Üstündağ, and A. Karadakovan, Assessment of Frailty in the Elderly. Florence Nightingale J Nurs, 2021. 29(1): p. 2-8.
153. Panda, M., et al., Assessment of frailty and outcome of an ethnogeriatric population in periurban slums of Delhi, India - An interventional strategy in a primary health care setting. J Family Med Prim Care, 2021. 10(6): p. 2272-2278.
154. Volle, K., et al., Prevalence and Prognosis Impact of Frailty Among Older Adults in Cardiac Intensive Care Units. CJC Open, 2021. 3(8): p. 1010-1018.
155. Sharma, Y., et al., Nutritional risk assessed by the Malnutrition Universal Screening Tool as a predictor of frailty in acutely hospitalised older patients: An observational study. Asia Pac J Clin Nutr, 2021. 30(2): p. 185-191.
156. Ribeiro, E.G., et al., Frailty in the elderly: screening possibilities in Primary Health Care. Rev Bras Enferm, 2021. 75(2): p. e20200973.
157. Andrew, M.K. and K. Rockwood, Making our health and care systems fit for an ageing population: considerations for Canada. Can Geriatr J, 2014. 17(4): p. 133-5.
158. Abdelhafiz, A.H. and A.J. Sinclair, Metabolic phenotypes explain the relationship between dysglycaemia and frailty in older people with type 2 diabetes. J Diabetes Complications, 2022. 36(4): p. 108144.
159. Asik, Z. and M. Özen, Evaluation of frailty and neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios relationship in elderly people. Nagoya J Med Sci, 2022. 84(1): p. 101-110.
160. Del Brutto, O.H., et al., Pre-Existing Frailty is Unrelated to Progression of Diffuse Subcortical Damage of Vascular Origin: A Longitudinal Prospective Study in Community-Dwelling Older Adults. J Prim Care Community Health, 2022. 13: p. 21501319221092245.
161. Shwe, P.S., et al., Anticholinergic burden and poor oral health are associated with frailty in geriatric patients undergoing inpatient rehabilitation: A cross-sectional study. Gerodontology, 2022.
162. Rech, R.S., et al., Factors associated with frailty in patients with neurodegenerative diseases. Codas, 2022. 34(5): p. e20200214.
163. Vitolo, M., et al., DIGItal Health Literacy after COVID-19 Outbreak among Frail and Non-Frail Cardiology Patients: The DIGI-COVID Study. J Pers Med, 2022. 13(1).
164. Goktas, S., et al., Frailty in older Turkish cancer patients undergoing post-surgical adjuvant chemotherapy. Int J Palliat Nurs, 2022. 28(12): p. 590-599.
165. Nguyen, A.T., et al., Walking Speed Assessed by 4-Meter Walk Test in the Community-Dwelling Oldest Old Population in Vietnam. Int J Environ Res Public Health, 2022. 19(16).
166. Harrison, S., et al., Frailty in the over 65's undergoing elective surgery (FIT-65) - a three-day study examining the prevalence of frailty in patients presenting for elective surgery. Perioper Med (Lond), 2022. 11(1): p. 42.
167. Burfeind, K.G., et al., Potentially Inappropriate Medication Administration Is Associated With Adverse Postoperative Outcomes in Older Surgical Patients: A Retrospective Cohort Study. Anesth Analg, 2022. 135(5): p. 1048-1056.
168. Studzińska, K., et al., Employing the Multivariate Edmonton Scale in the Assessment of Frailty Syndrome in Heart Failure. J Clin Med, 2022. 11(14).
169. Laic, R.A.G., et al., Profound prospective assessment of radiological and functional outcome 6 months after TBI in elderly. Acta Neurochir (Wien), 2023.
170. Saunders, R., et al., Frailty and pain in an acute private hospital: an observational point prevalence study. Sci Rep, 2023. 13(1): p. 3345.
171. Yüceler Kaçmaz, H., et al., Prevalence and factors associated with frailty in older hospitalized patients. Rev Clin Esp (Barc), 2023. 223(2): p. 67-76.
172. Bul, M., et al., Frailty and oral anticoagulant prescription in adults with atrial fibrillation: A systematic review. Aging Med (Milton), 2023. 6(2): p. 195-206.