Frailty detection by healthcare professionals: a systematic review of the available English and French tools and their validation

Bamps, Julien; Capouillez, Bastien; Rinaldi, Romina; Patris, Stéphanie

doi:10.1007/s41999-023-00806-w

Cited by 5 publications

(1 citation statement)

References 84 publications

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“…Frailty is a heterogeneous syndrome and can be difficult to operationalize because consensus on a clear and definite definition is lacking [6,7]. Many different screening or assessment tools have been developed, with or without the need 2 of 12 of validation in larger cohorts, and with great heterogeneity among the tools, making a comparison of frailty between cohorts complicated [9][10][11]. A comprehensive geriatric assessment-based Frailty Index could overcome these issues, but a disadvantage is that it cannot easily be applied at the bed-side [7,12].…”

Section: Introductionmentioning

confidence: 99%

The Use of Oral Anticoagulation Is Not Independently Associated with Mortality in Frail Older Patients with Repeated Falls

Zwart,

Walgers,

Hemels

et al. 2023

JCM

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Background: Particularly in frail patients, anticoagulation may be underused because of the fear of bleeding. Objective: To determine whether the use of antithrombotic medication is an independent risk factor for mortality in frail elderly with repeated falls. Methods: All patients aged 65 years or older at the Fall and Syncope Clinic were eligible. Frailty was calculated with a Frailty Index (FI) based on the accumulation of deficits model. Risks were calculated with a cox regression analysis, adjusted for age, sex, and Frailty Index. Results: 663 patients were included in this analysis. The median age was 80 years, 438 were women (66%), 73% had polypharmacy, and 380 patients (57%) had cognitive impairment. The mean FI was 0.23 (sd 0.09), 182 patients were moderately frail (27.5%), and 259 (39.1%) were severely frail. A total of 140 (21%) used oral anticoagulation and 223 (34%) used antiplatelet agents. A total of 196 patients (29.6%) died during follow-up. In the adjusted cox regression model, the use of neither antiplatelets nor anticoagulation was associated with mortality. A strong association was found with frailty (HR 74.0, 95% CI 13.1–417.3) and a weak association with age (HR 1.05, 95% CI 1.03–1.08). A lower risk of mortality was seen in women (HR 0.5, 95% CI 0.3–0.6). Conclusions: In this cohort of frail older patients, there was no independent association between the use of antithrombotic medication and mortality. A strong association with mortality was found with frailty, a weak association was found with age, and a lower mortality risk was found in women. Our data indicate that the fear of bleeding or increased mortality in frail patients with an indication for oral anticoagulation may be unjustified.

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