Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug;73(8):2571-2578.
doi: 10.1111/jgs.19438. Epub 2025 Mar 15.

The Implementation of Frailty Assessment Tools in the Acute Care Setting: A Scoping Review

Harneet Hothi  1   2 , Arianna R Paolone  2   3 , Matteen Pezeshki  2 , Lauren E Griffith  4   5 , Courtney C Kennedy  6   7 , Darryl P Leong  8   9 , Maura Marcucci  4   5   9   10 , Alexandra Papaioannou  5   6   7 , Justin Lee  2   5   6   7
Affiliations

The Implementation of Frailty Assessment Tools in the Acute Care Setting: A Scoping Review

Harneet Hothi et al. J Am Geriatr Soc. 2025 Aug.

Abstract

Background: Frailty is a syndrome of increased vulnerability to health stressors that is associated with adverse health outcomes. There is no universally accepted method of measuring frailty, and choosing among the many tools is often confusing for clinicians. Moreover, the acute care setting presents unique challenges to the operationalization of frailty measurement, and implementation into daily clinical practice has been variable. The objective of this scoping review was to map out and synthesize how frailty is being measured and used in the acute care setting.

Methods: We used Arksey and O'Malley's methodological framework for scoping reviews. We searched MEDLINE, EMBASE, CINAHL, SCOPUS, and Google Scholar for primary studies assessing frailty in the acute care setting from inception to May 2023.

Results: Our search resulted in 8834 articles, of which 2554 met inclusion criteria. Most articles (75%) were published in the last 5 years. The top three most frequently used methods of frailty measurement were the Frailty Index (41.0%), the Clinical Frailty Scale (23.3%), and the Fried Frailty Phenotype (9.3%). More than one frailty assessment tool was used in 11.2% of studies. While 99.6% of studies measured frailty assessment to evaluate the association of frailty with adverse outcomes or the validity of specific frailty tools, only 0.4% measured frailty to prospectively adapt healthcare provision.

Conclusion: There is an abundance of evidence demonstrating that frailty in acute care is associated with adverse health outcomes, with relatively scarce evidence on the effect of frailty assessment on prospectively adapting care. Future research focusing on the prospective management of frailty in acute care is needed.

Keywords: acute care; frailty; frailty assessment.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram.
FIGURE 2
FIGURE 2
Frequency and distribution of the three most commonly used frailty assessment tools by year (January 2014 to May 2023) and number of studies.
See this image and copyright information in PMC

References

    1. Theou O., Squires E., Mallery K., et al., “What Do We Know About Frailty in the Acute Care Setting? A Scoping Review,” BMC Geriatrics 18, no. 1 (2018): 139, 10.1186/s12877-018-0823-2. - DOI - PMC - PubMed
    1. Searle S. D., Mitnitski A., Gahbauer E. A., Gill T. M., and Rockwood K., “A Standard Procedure for Creating a Frailty Index,” BMC Geriatrics 8, no. 1 (2008): 24, 10.1186/1471-2318-8-24. - DOI - PMC - PubMed
    1. Xue Q. L., “The Frailty Syndrome: Definition and Natural History,” Clinics in Geriatric Medicine 27, no. 1 (2011): 1–15, 10.1016/j.cger.2010.08.009. - DOI - PMC - PubMed
    1. Canadian Institute for Health Information , “A Profile of Hospitalized Seniors at Risk of Frailty in Canada—Infographic.” 2022. https://www.cihi.ca/en/a‐profile‐of‐hospitalized‐seniors‐at‐risk‐of‐frai....
    1. Lekan D. A., Collins S. K., and Hayajneh A. A., “Definitions of Frailty in Qualitative Research: A Qualitative Systematic Review,” Journal of Aging Research 2021 (2021): 6285058, 10.1155/2021/6285058. - DOI - PMC - PubMed

Publication types

LinkOut - more resources