Table.
Frailty measures in included studies
| Components | Range and categorisation | Included studies (n) | Outcomes reported in included studies | |
|---|---|---|---|---|
| Frailty phenotype* | Five components: unintentional weight loss, exhaustion, low grip strength, slow walking pace, and low physical activity | 1–2 criteria: pre-frail; ≥3 criteria: frail | 69 | Mortality (n=2); HbA1c (n=1); complications† (n=1); cognitive impairment (n=2); disability (n=1); QOL (n=1) |
| Frailty index* | Count of health-related deficits (≥30, type and number of chosen deficits can vary between studies); total present divided by number of possible deficits | Range 0–1; sometimes categorised (threshold for frailty varies [eg, 0·2, 0·24]) | 16 | Mortality (n=3); hospitalisation (n=1); HbA1c (n=1); complications† (n=1); disability (n=1) |
| Fatigue, resistance, ambulation, illnesses, & loss of weight scale | Five components (weight loss, fatigue, weakness, ambulation, illness, or comorbidity) | 1–2 criteria: pre-frail; ≥3 criteria: frail | 10 | Mortality (n=4); hospitalisation (n=4); emergency department visit (n=2); disability (n=2); complications† (n=2); depression (n=1) |
| Clinical frailty scale | Clinical tool based on functional status | Ranges 1 (very fit) to 9 (terminally ill); some dichotomise frail as ≥5 | 5 | Mortality (n=2); HbA1c (n=2); complications† (n=1) |
| Edmonton frailty scale | Nine components: cognition, general health, functional independence, social support, medication, nutrition, mood, continence, and functional performance | Score 0–17; mild (7–8); moderate (9–10); severe frailty (≥11) | 4 | Complications† (n=2); depression (n=1); QOL (n=1) |
| Johns Hopkins adjusted clinical groups | Weighted comorbidity score identified from electronic medical records | Presence of frailty identified by specific indicator conditions | 3 | HbA1c (n=1); complications† (n=1) |
| Kihon checklist | Self-administered checklist (components: activities of daily living, exercise, falling, nutrition, oral health, cognition, and depression) | Range 0–25; pre-frail (4–7); frail (≥8) | 3 | None |
| Comprehensive geriatric assessment | Multidisciplinary assessment, typically led by a geriatrician, aiming to reach a holistic assessment of health and wellbeing | Frailty identified by clinical judgement rather than predefined criteria | 2 | Hospitalisation (n=1); hypoglycaemia (n=1); complications† (n=1); depression (n=1); cognitive impairment (n=1); QOL (n=1) |
| Electronic frailty index | Count of deficits identified from electronic medical records, based on the Frailty index approach | Mild (0·12–0·24); moderate (0·24–0·36); severe frailty (>0·36) | 2 | HbA1c (n=1); complications† (n=1) |
| Frailty risk class | List of indicator conditions identified from electronic medical records | Presence of frailty identified by specific indicator conditions | 2 | Mortality (n=1) |
| Frailty risk score | Count of 16 frailty risk factors (symptoms, behavioural factors, biomarkers, and nutritional factors) | Range 0–16 | 1 | Mortality (n=1); hospitalisation (n=1); HbA1c (n=1) |
| Frailty staging system | Seven components (disability, mobility, cognition, vision, hearing, continence, and social support) | Range 0–7; mild (1) moderate (2–3); severe frailty (≥4) | 1 | Mortality (n=1); cognitive impairment (n=1) |
| Frailty trait score | 12 items across seven components (nutrition, activity, nervous system, vascular system, weakness, endurance, and slowness) | Range 0–49 | 1 | None |
| Gill index | Composite of chair stand and walking speed tests | Moderate (unable to carry out one element) or severe frailty (both elements) | 1 | None |
| Groningen frailty indicator | 15 items across four domains (physical, cognitive, social, and psychological) | Range 0–15; ≥4 indicates frailty | 1 | None |
| Modified physical performance test | Nine item instrument assessing physical tasks | Range 0–36; moderate (22–29); severe frailty (≤21) | 1 | Complications† (n=1) |
| QFrailty | Algorithm based on electronic medical records combining mortality (QMortality score) and hospital admission (QAdmission score) risk | Categorised as mild, moderate, and severe frailty | 1 | None |
| RAND-36 questionnaire | Physical function sub-scale of the RAND-36 quesionnaire | Range 0–100; score <80 taken to indicate frailty | 1 | Mortality (n=1); complications† (n=1) |
| Study of osteoporotic fracture frailty indicator | Three components (weight loss, chair stand, and exhaustion) | One component: pre-frail; two to three components: frail | 1 | None‡ |
| Vulnerable elders survey (VES-13) | Telephone questionnaire with 13 components (age, self-rated health, physical function, and disability) | Score ≥4=frail | 1 | HbA1c (n=1); complications† (n=1) |
HbA1c=glycated haemoglobin. QOL=quality of life.
*
Three studies using these measures assessed more than one measure.
†
Diabetes-specific outcomes or complications (ie, microvascular or macrovascular).
‡
These studies considered prevalence of frailty only (ie, they did not assess the association between frailty and any other outcome).