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
Meta-Analysis
. 2025 May;20(3):e70030.
doi: 10.1111/opn.70030.

Diagnostic Accuracy of Self-Reported Tools for Frailty Assessment in Older Adults With Cancer: A Diagnostic Meta-Analysis

Dwi Apriadi  1   2 , Saranya Pimolkatekul  3 , Evi Susanti  2 , Hsiao-Yean Chiu  1   4   5   6 , Hui-Chuan Huang  1
Affiliations
Meta-Analysis

Diagnostic Accuracy of Self-Reported Tools for Frailty Assessment in Older Adults With Cancer: A Diagnostic Meta-Analysis

Dwi Apriadi et al. Int J Older People Nurs. 2025 May.

Abstract

Introduction: Questionnaires are commonly used for rapid frailty assessment. However, which scale is most appropriate for the identification of frailty in older adults with cancer remains unclear.

Objective: A diagnostic meta-analysis was conducted to examine the sensitivity and specificity of questionnaire-based assessment tools in detecting frailty among older adults with cancer.

Methods: Five databases were searched for eligible studies from inception to January 26, 2025. Study quality was evaluated using the revised Quality Assessment of Diagnostic Accuracy Studies tool. The pooled sensitivity and specificity of the frailty assessment tools were assessed through a bivariate random-effects model. Factors influencing the heterogeneity of sensitivity and specificity values were assessed through moderator analysis, which comprised a subgroup analysis and metaregression.

Results: Five questionnaire-based tools (i.e., the Edmonton Frailty Scale, FRAIL scale, Groningen Frailty Indikator [GFI], Tilburg Frailty Indikator, and Vulnerable Elders Survey-13 [VES-13]) for assessing frailty in older adults with cancer were identified in the literature; the most commonly used were the GFI and VES-13. The sensitivity and specificity of the GFI (67% and 81%, respectively) and VES-13 (65% and 81%) were calculated. Studies with a high proportion of male participants had poorer GFI sensitivity. Older patient samples were associated with lower VES-13 sensitivity, and a high prevalence of frailty or patients having stage III-IV cancer was associated with higher sensitivity.

Conclusion: The GFI and VES-13 demonstrated high specificity but low sensitivity for frailty assessment in older adults with cancer. Frequent assessment with the GFI or VES-13 is recommended to improve frailty detection.

Implications for practice: Health-care professionals, including oncology nurses, care managers, and oncologists, can incorporate the GFI and VES-13 into cancer care settings to improve early frailty detection and management. Pre-Registration: The study protocol was registered at PROSPERO (CRD42024505836).

Keywords: cancer; diagnostic accuracy; frailty; older adult; sensitivity; specificity.

PubMed Disclaimer

Similar articles

See all similar articles

References

    1. Almugbel, F. A., N. Timilshina, N. AlQurini, et al. 2021. “Role of the Vulnerable Elders Survey‐13 Screening Tool in Predicting Treatment Plan Modification for Older Adults With Cancer.” Journal of Geriatric Oncology 12, no. 5: 786–792. https://doi.org/10.1016/j.jgo.2020.12.002.
    1. Ambagtsheer, R. C., R. Visvanathan, E. Dent, S. Yu, T. J. Schultz, and J. Beilby. 2020. “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.” Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 75, no. 6: 1134–1142. https://doi.org/10.1093/gerona/glz260.
    1. Baitar, A., F. Van Fraeyenhove, A. Vandebroek, et al. 2013. “Evaluation of the Groningen Frailty Indicator and the G8 Questionnaire as Screening Tools for Frailty in Older Patients With Cancer.” Journal of Geriatric Oncology 4, no. 1: 32–38. https://doi.org/10.1016/j.jgo.2012.08.001.
    1. Belmin, J., L. Khellaf, S. Pariel, et al. 2020. “Validation of the French Version of the Vulnerable Elders Survey‐13 (VES‐13).” BMC Medical Research Methodology 20, no. 1: 21. https://doi.org/10.1186/s12874‐020‐0910‐x.
    1. Biganzoli, L., L. Boni, D. Becheri, et al. 2013. “Evaluation of the Cardiovascular Health Study (CHS) Instrument and the Vulnerable Elders Survey‐13 (VES‐13) in Elderly Cancer Patients. Are we Still Missing the Right Screening Tool?” Annals of Oncology 24, no. 2: 494–500. https://doi.org/10.1093/annonc/mds331.

LinkOut - more resources