Table 1.
Characteristics of included studies
| Study name and sources | Aims of study | Study typea | Country and years data collected | Sample characterisation | Age mean (SD) | Female % | Nb | Frailty instrument | QOL instrument/description |
|---|---|---|---|---|---|---|---|---|---|
| Ament 2014 [23] | Study whether physically frail older people are more at risk for developing IADL disability, decreased quality of life, and hospital admission if they also suffer from cognitive, social, or psychological frailty. | → | Netherlands 2010; 2011 | older people with frailty | 78.1 (4.9) | 60% | 334 | Groningen Frailty Indicator | “Quality of life” (unreferenced single-item general assessment) |
| Bilotta 2010 [24, 45] | Investigate dimensions and correlates of QOL associated with frailty status among community-dwelling older outpatients. | ✕ | Italy 2009 | Community-dwelling outpatients aged 65 + referred to a geriatric medicine clinic by GP, excluding patients with severe cognitive impairment | 81.5 (6.3) | 69% | 239 | Study of Osteoporotic Fractures criteria | Older People’s Quality of Life questionnaire |
| CSHA [25, 52] |
Test the hypothesis of the frailty identity crisis by studying whether psychological well-being was related to frailty and mortality in a sample of older community-dwelling Canadians. Examine the relationship between psychological well-being and depression in older adults and the relative contribution these psychological factors have on risk of functional disability, frailty, and mortality. |
→ | Canada 1996–1997; 2001–2002 | English- and French-speaking Canadians aged 65 years and older. The longitudinal analyses were restricted to community-dwelling older adults without dementia | 79.1 (6.4) | 61% | 5703 | Cumulative Deficit Model (33 deficits frailty index) | Ryff Psychological Well-Being scale |
| Chang 2012 [26] | Identify the incidence of frailty and to investigate the relationship between frailty status and health-related quality of life (HRQoL) in the community-dwelling elderly population who utilise preventive health services. | ✕ | Taiwan 2011 | older people following an extended hospital episode of care | 74.6 (6.3) | 53% | 374 | Fried phenotype model |
SF-36 “health-related quality of life” |
| Chang 2016 [27] | Examine the independent effect of frailty on quality of life of community-dwelling older adults | ✕ | Taiwan years not reported | community-dwelling older people | 74.8 (7.0) | 57% | 239 | Study of Osteoporotic Fractures criteria | WHOQOL-BREF |
| Coelho 2015 [28] | Present the translation and validation process of the Portuguese version of the Tilburg Frailty Indicator | ✕ | Portugal 2013 | Community-dwelling. Users of institutions such as social, recreation and day care centres and senior academies. | 79.2 (7.3) | 76% | 252 | Tilburg Frailty Indicator |
WHOQOL-OLD; EUROHIS-QOL |
| ELSA (Gale 2014) [29] | Identify whether psychological well-being was associated with incidence of physical frailty | → | UK 2004–2005; 2008–2009 | People aged ≥ 60 years | 70.2 (7.7) | 55% | 2557 | Fried phenotype model |
CASP-19 “psychological well-being” |
| ELSA (Hubbard 2014) [30] + | First, to investigate the association between frailty and subjective well-being in older people; second, to explore the impact of household wealth and income on this relationship. | ✕ | UK 2002–2003 | Community-dwelling adults aged 65–79 | 71 | 52% | 3206 | Cumulative Deficit Model (50 deficits frailty index) |
CASP-19 “subjective well-being” |
| Freitag 2016 [31] | Adaptation of the TFI to a German version and to test the reliability and validity of the German adaptation of the TFI in a sample of older adults | ✕ | Germany 2012 | Older adults living at home | 75.3 (5.7) | 62% | 210 | Tilburg Frailty Indicator |
SF-12 “health-related quality of life”; EUROHIS-QOL |
| Gobbens 2012 [32, 46, 47] | To assess the predictive validity of frailty and its domains (physical, psychological and social), as measured by the Tilburg Frailty Indicator (TFI), for the adverse outcomes disability, health care utilisation and quality of life | → | Netherlands 2008; 2009; 2010 | community-dwelling persons aged 75 years and older | 80.3 (3.8) | 57% | 479; 336; 266 | Tilburg Frailty Indicator | WHOQOL-BREF |
| Gobbens 2013 [33, 48] + | Test the hypothesis that the prediction of quality of life by physical frailty components is improved by adding psychological and social frailty components | ✕ | Netherlands 2009–2010 | Dutch older people who voluntarily complete a web-based questionnaire | 73.4 (5.8) | 33% | 1031 | Tilburg Frailty Indicator | WHOQOL-BREF |
| Jurschik 2012 [34] | Assess the prevalence of frailty and to identify factors associated with frailty in older people living in the community through a cross-sectional study of community-dwelling persons age 75 and older | ✕ | Spain 2009–2010 |
community-dwelling persons aged 75 and older |
81.3 (5.0) | 60% | 640 | Fried phenotype model |
SF-36 “health-related quality of life” |
| Kanauchi 2008 [35] | Examine the health-related quality of life (HRQOL) and the effect of frailty in elderly patients with cardiometabolic risk factors | ✕ | Japan 2007 | elderly patients with cardiometabolic risk factors (diabetes, hypertension, dyslipidaemia or chronic kidney disease) | 72.9 (5.1) | 44% | 101 | Hebrew Rehabilitation Center for Aged Vulnerability Index and the Vulnerable Elders Survey | WHOQOL-BREF |
| Lahousse 2014 [36] + | Investigate the prevalence of frailty in a Dutch elderly population and to identify adverse health outcomes associated with the frailty phenotype independent of the comorbidities | ✕c | Netherlands 2009–2012 | population-based cohort study in persons aged ≥ 55 years | 74 [9] d | 56% | 2833 | Fried phenotype model |
EuroQol Visual analogue scale (EQ-VAS) “quality of life” |
| Lenardt 2014 [37, 49] + | Identifying the quality of life of frail elderly patients, users of primary care services | ✕ | Brazil 2013 | Elderly patients of a primary health care service | 70.9 (7.4) | 51% | 203 | Fried phenotype model |
SF-36 “quality of life” |
| Lin 2011 [38, 50] + | Examine the domains and degrees of functioning and well-being that are affected by the frailty of elders residing in the community in Taiwan | ✕ | Taiwan 2009 | Population-based survey of elders residing in the community | 73.9 | 48% | 903 | Fried phenotype model |
SF-36 “health-related quality of life” |
| Masel 2009 [39, 51] | Elicit the relationship between being non-frail, pre-frail or frail and HRQOL in a representative sample of older Mexican Americans | ✕ | USA 2005–2006 | Representative sample of older Mexicans living in Texas | 82.3 (4.5) | 64% | 1011 | Fried phenotype model |
SF-36 “health-related quality of life” |
| Pinto 2016 [40] | Identify the influence of self-rated health as a mediator of the relationships between objective indicators of physical and mental health, as well as the elderly’s life satisfaction | ✕ | Brazil years not reported | People aged > 65, excluding severe cognitive impairment, low mobility, sequelae of stroke, Parkinson’s disease, severe deficits in hearing, vision, communication or being terminally ill | 72.7 (5.4) | 66% | 2164 | Fried phenotype model | “Life satisfaction” (unreferenced multi-item) |
| Simone 2013 [41] | examine differences in leisure activity engagement by frailty status, and evaluate the link between functional status and subjective well-being | ✕ | USA years not reported | older people | 74 (10.5) | 82% | 95 | Groningen Frailty Indicator | Satisfaction With Life Scale |
| St John 2013 [42] | determine if (1) frailty is associated with life satisfaction (LS) in community-dwelling older adults in cross-sectional analyses; (2) frailty predicts LS five years later and (3) specific domains of LS are preferentially associated with frailty | → | Canada years not reported | older people | 77.5 | 59% | 988 | Brief frailty measure and Frailty Index | Life Satisfaction terrible-delightful scale |
| Wu 2013 [43] | Test and validate a Chinese Taiwan version of the CASP-19 and to analyse its psychometric properties in a community-dwelling older Chinese (Taiwanese) population in Taipei City, Taiwan | ✕ | Taiwan 2010 | sample came from the community-dwelling older participants of a senior citizen’s health examination in Taipei City Hospital, Renai Branch in 2010 or earlier | 75.5 (6.5) | 50% | 699 | Chinese Canadian study of health and aging clinical frailty scale |
CASP-19 “quality of life” |
| Yang 2016 [44] | Examine the relationship between frailty and life satisfaction and the roles of age and social vulnerability underlying the links in Chinese older adults | ✕ | China 2013 | Older adults in Shanghai | 75.2 (7.6) | 54% | 1970 | Cumulative Deficit Model (52 deficit frailty index) | “Life satisfaction” (unreferenced multi-item) |
a✕ cross-sectional; → longitudinal
bThe number of participants in the main analyses of the variables of interest
cThe article reports longitudinal data but only baseline analyses of the variables of interest
dmedian [IQR]
+Additional data provided by authors