Frailty assessment tools for preoperative evaluation of older adults: scoping review.
14 affiliations
- 1Department of Surgery, Division of General Surgery, University of Toronto, Toronto, Ontario, Canada.
- 2Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
- 3Division of Geriatric Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
- 4Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.
- 5Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
- 6Department of Anesthesiology and Pain Medicine, St. Michael's Hospital and University of Toronto, Toronto, Ontario, Canada.
- 7Department of Anesthesiology, McMaster University, Hamilton, Ontario, Canada.
- 8Department of Internal Medicine, University of Ottawa, Ottawa, Ontario, Canada.
- 9Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
- 10Department of Emergency Medicine, Cambridge Memorial Hospital, Cambridge, Ontario, Canada.
- 11Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
- 12Division of Gynecologic Oncology, Université de Montréal, Montreal, Quebec, Canada.
- 13Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
- 14Department of Medicine, University Health Network and University of Toronto, Toronto, Ontario, Canada.
Abstract
Background
Optimal frailty assessment in surgery remains unclear due to insufficient tool performance evaluations. This scoping review summarizes evidence on frailty tools in the preoperative setting, focusing on key performance metrics.Methods
Following JBI and PRISMA-ScR recommendations, the MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health Literature databases were systematically searched (2005-May 2026), for studies evaluating performance metrics of frailty tools in adults aged ≥ 65 years undergoing major intracavitary surgery. Two reviewers conducted screening and data charting. Data were analysed on settings, surgical types, and six performance metrics across measurement properties, clinical impact, and pragmatic factors.Results
From 12 272 records, 160 unique studies on 35 frailty tools were included. Some tools were extensively investigated (up to 41 studies and 11 287 participants), whereas 40% of tools had been investigated in only one study. Predictive validity was commonly studied, whereas reliability, clinical impact, and pragmatic factors were less explored. The Clinical Frailty Scale was extensively studied, covering four of six performance metrics across diverse settings and surgical types. The Edmonton Frail Scale was the only tool investigated across all six metrics, although reliance on performance and cognitive testing may hinder implementation. The FRAIL scale, Geriatric 8, and Vulnerable Elders Survey-13 are simple questionnaires, with the FRAIL scale being the most extensively investigated (five of six metrics).Conclusion
Several frailty assessment tools show promise based on investigation extent and features. This review aids clinical teams in identifying tools that meet specific local needs. Further research should focus on clinical impact and pragmatic factors, as well as tool-specific meta-analyses of performance metrics to enhance tool selection and implementation.
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BibTeX
@article{chesney2026frailty,
title = {{Frailty assessment tools for preoperative evaluation of older adults: scoping review.}},
author = {Tyler R Chesney and Camilla L Wong and Andrea C Tricco and Duminda N Wijeysundera and Marisa Louridas and Kesikan Jayaraj and Claire Sethuram and Amanda Mac and Shawn Khan and Victoria B Anthes and Madeline McDonald and Betty Yibrehu and Amanda Poxon and Anas Samman and Valerie Kim and Karim S Ladha and Teruko Kishibe and Samuel Dubé and Martine Puts and Shabbir M H Alibhai and Julian F Daza},
journal = {BJS open},
year = {2026},
month = sep,
doi = {10.1093/bjsopen/zrag129},
url = {https://europepmc.org/article/MED/42925091},
note = {CC BY},
}
RIS
TY - JOUR
TI - Frailty assessment tools for preoperative evaluation of older adults: scoping review.
AU - Tyler R Chesney
AU - Camilla L Wong
AU - Andrea C Tricco
AU - Duminda N Wijeysundera
AU - Marisa Louridas
AU - Kesikan Jayaraj
AU - Claire Sethuram
AU - Amanda Mac
AU - Shawn Khan
AU - Victoria B Anthes
AU - Madeline McDonald
AU - Betty Yibrehu
AU - Amanda Poxon
AU - Anas Samman
AU - Valerie Kim
AU - Karim S Ladha
AU - Teruko Kishibe
AU - Samuel Dubé
AU - Martine Puts
AU - Shabbir M H Alibhai
AU - Julian F Daza
PY - 2026
DA - 2026/09/01
JO - BJS open
DO - 10.1093/bjsopen/zrag129
UR - https://europepmc.org/article/MED/42925091
AB - Background Optimal frailty assessment in surgery remains unclear due to insufficient tool performance evaluations. This scoping review summarizes evidence on frailty tools in the preoperative setting, focusing on key performance metrics.Methods Following JBI and PRISMA-ScR recommendations, the MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health Literature databases were systematically searched (2005-May 2026), for studies evaluating performance metrics of frailty tools in adults aged ≥ 65 years undergoing major intracavitary surgery. Two reviewers conducted screening and data charting. Data were analysed on settings, surgical types, and six performance metrics across measurement properties, clinical impact, and pragmatic factors.Results From 12 272 records, 160 unique studies on 35 frailty tools were included. Some tools were extensively investigated (up to 41 studies and 11 287 participants), whereas 40% of tools had been investigated in only one study. Predictive validity was commonly studied, whereas reliability, clinical impact, and pragmatic factors were less explored. The Clinical Frailty Scale was extensively studied, covering four of six performance metrics across diverse settings and surgical types. The Edmonton Frail Scale was the only tool investigated across all six metrics, although reliance on performance and cognitive testing may hinder implementation. The FRAIL scale, Geriatric 8, and Vulnerable Elders Survey-13 are simple questionnaires, with the FRAIL scale being the most extensively investigated (five of six metrics).Conclusion Several frailty assessment tools show promise based on investigation extent and features. This review aids clinical teams in identifying tools that meet specific local needs. Further research should focus on clinical impact and pragmatic factors, as well as tool-specific meta-analyses of performance metrics to enhance tool selection and implementation.
SN - 2474-9842
ER -