The prevalence of frailty and pre-frailty among geriatric hospital inpatients and its association with economic prosperity and healthcare expenditure: A systematic review and meta-analysis of 467,779 geriatric hospital inpatients

Ageing Research Reviews - Tập 80 - Trang 101666 - 2022
Paul Doody1,2,3, Evans A. Asamane1,4, Justin A. Aunger1,5, Bridgitte Swales1,6, Janet M. Lord7,8, Carolyn A. Greig1,7,8, Anna C. Whittaker1,6
1School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, United Kingdom
2The Irish Longitudinal Study on Ageing, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
3Mercer’s Institute for Successful Ageing, St. James Hospital, Dublin 8, Ireland
4Institute of Applied Health Research, University of Birmingham, United Kingdom
5School of Health Sciences, University of Surrey, United Kingdom
6Faculty of Health Sciences and Sport, University of Stirling, United Kingdom
7MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, United Kingdom
8NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, United Kingdom

Tài liệu tham khảo

United Nations Department of Economic and Social Affairs Population Division, 2019. United Nations Population Prospects 2019 (ST/ESA/SER.A/423).URL: 〈https://population.un.org/wpp/Publications/Files/WPP2019_Highlights.pdf〉. Accessed: 02/03/2020. Alonso Salinas, 2018, The role of frailty in acute coronary syndromes in the elderly, Gerontology, vol. 64, 422, 10.1159/000488390 Amblàs-Novellas, 2018, Frail-VIG index: a concise frailty evaluation tool for rapid geriatric assessment, BMC Geriatr., vol. 18, 1, 10.1186/s12877-018-0718-2 Andela, 2010, Prevalence of frailty on clinical wards: Description and implications, Int. J. Nurs. Pract., vol. 16, 14, 10.1111/j.1440-172X.2009.01807.x Andrew, 2017, The importance of frailty in the assessment of influenza vaccine effectiveness against influenza-related hospitalization in elderly people, J. Infect. Dis., vol. 216, 405, 10.1093/infdis/jix282 Attisano, 2017, SICI-GISE commuNity CAmpania survey doNna TAVI (INCANTA): perioperative and short-term outcome of transcatheter aortic valve implantation in women, G. Ital. di Cardiol. (2006), vol. 18, 27S Baldwin, 2014, The feasibility of measuring frailty to predict disability and mortality in older medical intensive care unit survivors, J. Crit. Care, vol. 29, 401, 10.1016/j.jcrc.2013.12.019 Blanco, 2017, Prognosis impact of frailty assessed by the Edmonton Frail Scale in the setting of acute coronary syndrome in the elderly, Can. J. Cardiol., vol. 33, 933, 10.1016/j.cjca.2017.03.026 Bo, 2015, Health status, geriatric syndromes and prescription of oral anticoagulant therapy in elderly medical in-patients with atrial fibrillation: a prospective observational study, Int. J. Cardiol., vol. 187, 123, 10.1016/j.ijcard.2015.03.334 Bo, 2016, Prevalence of and factors associated with prolonged length of stay in older hospitalized medical patients, Geriatr. Gerontol. Int., vol. 16, 314, 10.1111/ggi.12471 Borenstein, 2010, A basic introduction to fixed‐effect and random‐effects models for meta‐analysis, Res. Synth. Methods, vol. 1, 97, 10.1002/jrsm.12 Cheung, 2017, A prospective cohort study of older surgical inpatients examining the prevalence and implications of frailty, J. Clin. Gerontol. Geriatr., vol. 8 Chew, 2017, Impact of frailty and residual subsyndromal delirium on 1–year functional recovery: A prospective cohort study, Geriatr. Gerontol. Int., vol. 17, 2472, 10.1111/ggi.13108 Chia, 2016, ‘Start to finish trans-institutional transdisciplinary care’: a novel approach improves colorectal surgical results in frail elderly patients, Colorectal Dis., vol. 18, O43, 10.1111/codi.13166 Chong, 2017, Frailty and risk of adverse outcomes in hospitalized older adults: a comparison of different frailty measures, J. Am. Med. Dir. Assoc., vol. 18, 638.e7, 10.1016/j.jamda.2017.04.011 Clegg, 2013, Frailty in elderly people, Lancet (Br. Ed. ), vol. 381, 752, 10.1016/S0140-6736(12)62167-9 Coleman, 2012, Outcomes among older people in a post-acute inpatient rehabilitation unit, Disabil. Rehabil., vol. 34, 1333, 10.3109/09638288.2011.636136 Collard, 2012, Prevalence of frailty in community-dwelling older persons: a systematic review, J. Am. Geriatr. Soc., vol. 60, 1487, 10.1111/j.1532-5415.2012.04054.x Courtney-Brooks, 2012, Frailty: An outcome predictor for elderly gynecologic oncology patients, Gynecol. Oncol., vol. 126, 20, 10.1016/j.ygyno.2012.04.019 Crozier-Shaw, 2018, Too frail for surgery? A frailty index in major colorectal surgery, ANZ J. Surg., vol. 88, 1302, 10.1111/ans.14792 Dal Moro, 2017, Frailty and elderly in urology: Is there an impact on post-operative complications?, Cent. Eur. J. Urol., vol. 70, 197 Dent, 2014, Frailty and functional decline indices predict poor outcomes in hospitalised older people, Age Ageing, vol. 43, 477, 10.1093/ageing/aft181 Dent, 2019, Management of frailty: opportunities, challenges, and future directions, Lancet (Br. Ed. ), vol. 394, 1376, 10.1016/S0140-6736(19)31785-4 Doody, 2019, Assessing the feasibility and impact of specially adapted exercise interventions, aimed at improving the multi-dimensional health and functional capacity of frail geriatric hospital inpatients: protocol for a feasibility study, BMJ Open, vol. 9, 10.1136/bmjopen-2019-031159 Doody, 2019, Frailty Levels In Geriatric Hospital paTients (FLIGHT)—the prevalence of frailty among geriatric populations within hospital ward settings: a systematic review protocol, BMJ Open, vol. 9, 10.1136/bmjopen-2019-030147 Dorner, 2014, Association between nutritional status (MNA®-SF) and frailty (SHARE-FI) in acute hospitalised elderly patients, J. Nutr., Health Aging, vol. 18, 264, 10.1007/s12603-013-0406-z Drudi, 2018, Association of depression with mortality in older adults undergoing transcatheter or surgical aortic valve replacement, JAMA Cardiol., vol. 3, 191, 10.1001/jamacardio.2017.5064 Dutzi, 2017, Cognitive change in rehabilitation patients with dementia: prevalence and association with rehabilitation success, J. Alzheimer’S. Dis., vol. 60, 1171, 10.3233/JAD-170401 Eamer, 2018, Analysis of postdischarge costs following emergent general surgery in elderly patients, Can. J. Surg., vol. 61, 19, 10.1503/cjs.002617 Eeles, 2012, The impact of frailty and delirium on mortality in older inpatients, Age Ageing, vol. 41, 412, 10.1093/ageing/afs021 Ekerstad, 2011, Frailty is independently associated with short-term outcomes for elderly patients with non-ST-segment elevation myocardial infarction, Circulation, vol. 124, 2397, 10.1161/CIRCULATIONAHA.111.025452 Engelhardt, 2018, Frailty screening and a frailty pathway decrease length of stay, loss of independence, and 30-day readmission rates in frail geriatric trauma and emergency general surgery patients, J. Trauma Acute Care Surg., vol. 85, 167, 10.1097/TA.0000000000001931 Ferrero, 2017, Ovarian Cancer in Elderly Patients: Patterns of Care and Treatment Outcomes According to Age and Modified Frailty Index, Int. J. Gynecol. Cancer, vol. 27, 1863, 10.1097/IGC.0000000000001097 Ferrucci, 2002, Biomarkers of frailty in older persons, J. Endocrinol. Investig., vol. 25, 10 Fiatarone, 1994, Exercise training and nutritional supplementation for physical frailty in very elderly people, N. Engl. J. Med., vol. 330, 1769, 10.1056/NEJM199406233302501 Fried, 2001, Frailty in Older Adults: Evidence for a Phenotype, J. Gerontol. Ser. A, Biol. Sci. Med. Sci., vol. 56, M146, 10.1093/gerona/56.3.M146 Ga, 2018, Use of the Frailty Index and FRAIL-NH Scale for the Assessment of the Frailty Status of Elderly Individuals Admitted in a Long-term Care Hospital in Korea, Ann. Geriatr. Med. Res., vol. 22, 20, 10.4235/agmr.2018.22.1.20 Gill, 2006, Transitions Between Frailty States Among Community-Living Older Persons, Arch. Intern. Med. (1960), vol. 166, 418, 10.1001/archinte.166.4.418 Gleason, 2017, FRAIL Questionnaire Screening Tool and Short-Term Outcomes in Geriatric Fracture Patients, J. Am. Med. Dir. Assoc., vol. 18, 1082, 10.1016/j.jamda.2017.07.005 Goldfarb, 2018, Malnutrition and Mortality in Frail and Non-Frail Older Adults Undergoing Aortic Valve Replacement, Circ. (N. Y., N. Y. ), vol. 138, 2202 Guidet, 2018, Withholding or withdrawing of life-sustaining therapy in older adults (≥ 80 years) admitted to the intensive care unit, Intensive Care Med., vol. 44, 1027, 10.1007/s00134-018-5196-7 Gullón, 2018, Baseline functional status as the strongest predictor of in-hospital mortality in elderly patients with non-valvular atrial fibrillation: Results of the NONAVASC registry, Eur. J. Intern. Med., vol. 47, 69, 10.1016/j.ejim.2017.09.020 Handforth, 2015, The prevalence and outcomes of frailty in older cancer patients: A systematic review, Ann. Oncol., vol. 26, 1091, 10.1093/annonc/mdu540 Hanlon, 2020, Frailty measurement, prevalence, incidence, and clinical implications in people with diabetes: a systematic review and study-level meta-analysis, Lancet Healthy Longev., vol. 1, e106, 10.1016/S2666-7568(20)30014-3 Hartley, 2017, Clinical frailty and functional trajectories in hospitalized older adults: A retrospective observational study, Geriatr. Gerontol. Int., vol. 17, 1063, 10.1111/ggi.12827 He, 2019, Prevalence and Risk Factors for Frailty Among Community-Dwelling Older People in China: A Systematic Review and Meta-Analysis, J. Nutr., Health Aging, vol. 23, 442, 10.1007/s12603-019-1179-9 Heppenstall, 2011, Factors related to care home admission in the year following hospitalisation in frail older adults, Age Ageing, vol. 40, 513, 10.1093/ageing/afr045 Hewitt, 2016, Prevalence of multimorbidity and its association with outcomes in older emergency general surgical patients: An observational study; 27033960, BMJ Open, vol. 6, 10.1136/bmjopen-2015-010126 Hewitt, 2015, Prevalence of frailty and its association with mortality in general surgery; 25173599, Am. J. Surg., vol. 209, 254, 10.1016/j.amjsurg.2014.05.022 Higgins, 2002, Quantifying heterogeneity in a meta-analysis, Stat. Med., vol. 21, 1539, 10.1002/sim.1186 Higgins, 2003, Measuring inconsistency in meta-analyses, BMJ, vol. 327, 557, 10.1136/bmj.327.7414.557 Hii, 2014, Frailty in acute cardiology: comparison of a quick clinical assessment against a validated frailty assessment tool, Heart, lung Circ., vol. 24, 551, 10.1016/j.hlc.2014.11.024 Hilmer, 2011, Gentamicin pharmacokinetics in old age and frailty, Br. J. Clin. Pharmacol., vol. 71, 224, 10.1111/j.1365-2125.2010.03825.x Hoogendijk, 2019, Frailty: implications for clinical practice and public health, Lancet (Br. Ed. ), vol. 394, 1365, 10.1016/S0140-6736(19)31786-6 IBM Corp, 2020, IBM SPSS Statistics for Windows (Version 27.0). Available: 〈https://www.ibm.com/support/pages/downloading-ibm-spss-statistics-27〉. Ibrahim, 2019, The feasibility of assessing frailty and sarcopenia in hospitalised older people: a comparison of commonly used tools, BMC Geriatr., vol. 19, 42, 10.1186/s12877-019-1053-y Induruwa, 2017, Clinical frailty is independently associated with non-prescription of anticoagulants in older patients with atrial fibrillation, Geriatr. Gerontol. Int., vol. 17, 2178, 10.1111/ggi.13058 International Monetary Fund, 2019, World Economic Outlook (April 2019). Available: https://www.imf.org/external/datamapper/PPPPC@WEO/ADVEC/WEOWORLD. Downloaded: 02/05/2019. Jacobs, 2017, Clinical Relevance of Differences in Glomerular Filtration Rate Estimations in Frail Older People by Creatinine- vs. Cystatin C-Based Formulae, Drugs Aging, vol. 34, 445, 10.1007/s40266-017-0460-z Jokar, 2016, Emergency general surgery specific frailty index: A validation study, J. Trauma Acute Care Surg., vol. 81, 254, 10.1097/TA.0000000000001120 Joosten, 2014, Prevalence of frailty and its ability to predict in hospital delirium, falls, and 6-month mortality in hospitalized older patients, BMC Geriatr., vol. 14, 10.1186/1471-2318-14-1 Joseph, 2014, Superiority of Frailty Over Age in Predicting Outcomes Among Geriatric Trauma Patients: A Prospective Analysis, JAMA Surg., vol. 149, 766, 10.1001/jamasurg.2014.296 Joseph, 2016, The impact of frailty on failure-to-rescue in geriatric trauma patients: A prospective study, J. Trauma Acute Care Surg., vol. 81, 1150, 10.1097/TA.0000000000001250 Juma, 2016, Clinical frailty scale in an acute medicine unit: a simple tool that predicts length of stay, Can. Geriatr. J. CGJ, vol. 19, 34, 10.5770/cgj.19.196 Kang, 2015, Is frailty associated with short-term outcomes for elderly patients with acute coronary syndrome?, J. Geriatr. Cardiol.: JGC, vol. 12, 662 Karlekar, 2017, Creating new opportunities to educate families on the impact of frailty and cognitive impairment in a trauma intensive care unit: results of a quality improvement project, J. Palliat. Med., vol. 20, 193, 10.1089/jpm.2016.0244 Keevil, 2018, Care home residents admitted to hospital through the emergency pathway: characteristics and associations with inpatient mortality, J. R. Coll. Physicians Edinb., vol. 48, 202, 10.4997/jrcpe.2018.303 Kenig, 2015, Six screening instruments for frailty in older patients qualified for emergency abdominal surgery, Arch. Gerontol. Geriatr., vol. 61, 437, 10.1016/j.archger.2015.06.018 Khan, 2019, Failure to Rescue After Emergency General Surgery in Geriatric Patients: Does Frailty Matter?, J. Surg. Res., vol. 233, 397, 10.1016/j.jss.2018.08.033 Khandelwal, 2012, Frailty is associated with longer hospital stay and increased mortality in hospitalized older patients, J. Nutr., Health Aging, vol. 16, 732, 10.1007/s12603-012-0369-5 Kobe, 2016, Frailty Assessed by the Forecast is a Valid Tool to Predict Short-Term Outcome after Transcatheter Aortic Valve Replacement, Innov. (Phila., Pa. ), vol. 11, 407, 10.1177/155698451601100607 Kojima, 2015, Prevalence of Frailty in Nursing Homes: A Systematic Review and Meta-Analysis, J. Am. Med. Dir. Assoc., vol. 16, 940, 10.1016/j.jamda.2015.06.025 Kojima, 2017, Prevalence of frailty in Japan: A systematic review and meta-analysis, J. Epidemiol., vol. 27, 347, 10.1016/j.je.2016.09.008 Koyama, 2018, Preadmission frailty status as a powerful predictor of dependency after discharge among hospitalized older patients: A clinical‐based prospective study, Geriatr. Gerontol. Int., vol. 18, 1609, 10.1111/ggi.13537 Kusunose, 2018, Prognostic Value of Frailty and Diastolic Dysfunction in Elderly Patients, Circ. J.: Off. J. Jpn. Circ. Soc., vol. 82, 2103, 10.1253/circj.CJ-18-0017 Le Maguet, 2014, Prevalence and impact of frailty on mortality in elderly ICU patients: a prospective, multicenter, observational study, Intensive Care Med., vol. 40, 674 Lee, 2018, Toward Using a Smartwatch to Monitor Frailty in a Hospital Setting: Using a Single Wrist-Wearable Sensor to Assess Frailty in Bedbound Inpatients, vol. 64, 389 Ligthart-Melis, 2020, Frailty, Sarcopenia, and Malnutrition Frequently (Co-)occur in Hospitalized Older Adults: A Systematic Review and Meta-analysis, J. Am. Med. Dir. Assoc., vol. 21, 1216, 10.1016/j.jamda.2020.03.006 Lin, 2017, Perioperative assessment of older surgical patients using a frailty index - feasibility and association with adverse postoperative outcomes, Anaesth. Intensive Care, vol. 45, 676, 10.1177/0310057X1704500605 Llaó, 2018, Invasive strategy and frailty in very elderly patients with acute coronary syndromes, Eur.: J. Eur. Collab. Work. Group Interv. Cardiol. Eur. Soc. Cardiol., vol. 14, e336 Ma, 2013, Recurrent hospitalisation with pneumonia is associated with higher 1-year mortality in frail older people, Intern. Med. J., vol. 43, 1210, 10.1111/imj.12258 Madni, 2018, The Relationship Between Frailty and the Subjective Decision to Conduct a Goals of Care Discussion With Burned Elders, J. Burn care Res., vol. 39, 82 Marinus, 2021, Frailty is highly prevalent in specific cardiovascular diseases and females, but significantly worsens prognosis in all affected patients: A systematic review, Ageing Res. Rev., vol. 66, 10.1016/j.arr.2020.101233 Martín, 2018, Effect of a minimal-massive intervention in hospitalized older patients with oropharyngeal dysphagia: a proof of concept study, J. Nutr., Health Aging, vol. 22, 739, 10.1007/s12603-018-1043-3 Martínez-Velilla, 2018, Effect of Exercise Intervention on Functional Decline in Very Elderly Patients During Acute Hospitalization: A Randomized Clinical Trial, JAMA Intern. Med., vol. 179, 28, 10.1001/jamainternmed.2018.4869 Mason, 2018, Establishing a proactive geriatrician led comprehensive geriatric assessment in older emergency surgery patients: Outcomes of a pilot study, Int. J. Clin. Pract. (Esher), vol. 72 Maxwell, 2018, The FRAIL questionnaire: a useful tool for bedside screening of geriatric trauma patients, J. Trauma Nurs., vol. 25, 242, 10.1097/JTN.0000000000000379 McGuckin, 2018, The association of peri‐operative scores, including frailty, with outcomes after unscheduled surgery, Anaesthesia, vol. 73, 819, 10.1111/anae.14269 McIsaac, 2019, Derivation and validation of a generalizable preoperative frailty index using population-based health administrative data, Ann. Surg., vol. 270, 102, 10.1097/SLA.0000000000002769 Melo, 2020, Prevalence of frailty in Brazilian older adults: a systematic review and meta-analysis, J. Nutr., Health Aging, vol. 24, 708, 10.1007/s12603-020-1398-0 Moher, 2009, Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement, PLoS Med., vol. 6, 10.1371/journal.pmed.1000097 Morton, 2018, Is frailty a predictor of outcomes in elderly inpatients with acute kidney injury? A prospective cohort study, Am. J. Med., vol. 131, 1251, 10.1016/j.amjmed.2018.03.012 Muessig, 2018, Clinical Frailty Scale (CFS) reliably stratifies octogenarians in German ICUs: a multicentre prospective cohort study, BMC Geriatr., vol. 18, 162, 10.1186/s12877-018-0847-7 Müller, 2017, Impaired nutritional status in geriatric trauma patients, Eur. J. Clin. Nutr., vol. 71, 602, 10.1038/ejcn.2017.25 Munn, 2015, Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data, Int. J. Evid. -Based Healthc., vol. 13, 147, 10.1097/XEB.0000000000000054 Murray, 2018, Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017, Lancet (Br. Ed. ), vol. 392, 1995, 10.1016/S0140-6736(18)32278-5 Myint, 2018, Is anemia associated with cognitive impairment and delirium among older acute surgical patients?, Geriatr. Gerontol. Int., vol. 18, 1025, 10.1111/ggi.13293 Nguyen, 2016, Atrial fibrillation in older inpatients: are there any differences in clinical characteristics and pharmacological treatment between the frail and the non-frail?, Intern. Med. J., vol. 46, 86, 10.1111/imj.12912 Nolan, 2016, Frailty and its association with rehabilitation outcomes in a post-acute older setting, Int. J. Ther. Rehabil., vol. 23, 33, 10.12968/ijtr.2016.23.1.33 Oliveira, 2013, Prevalence of frailty syndrome in old people in a hospital institution, Rev. Lat. -Am. De. Enferm., vol. 21, 891, 10.1590/S0104-11692013000400009 Öztürk, 2017, Quality of life and fall risk in frail hospitalized elderly patients, Turk. J. Med. Sci., vol. 47, 1377, 10.3906/sag-1610-107 Page, 2021, Updating guidance for reporting systematic reviews: development of the PRISMA 2020 statement, J. Clin. Epidemiol., vol. 134, 103, 10.1016/j.jclinepi.2021.02.003 Papageorgiou, 2018, Frailty in elderly ICU patients in Greece: a prospective, observational study, Ann. Transl. Med., vol. 6, 111, 10.21037/atm.2018.02.03 Papakonstantinou, 2018, Frailty Status Affects the Decision for Long-Term Anticoagulation Therapy in Elderly Patients with Atrial Fibrillation, Drugs Aging, vol. 35, 897, 10.1007/s40266-018-0587-6 Parmar, 2019, Frailty in Older Patients Undergoing Emergency Laparotomy: Results From the UK Observational Emergency Laparotomy and Frailty (ELF) Study, Ann. Surg., vol. 273, 709, 10.1097/SLA.0000000000003402 Pasqualetti, 2018, Degree of peripheral thyroxin deiodination, frailty, and long-term survival in hospitalized older patients, J. Clin. Endocrinol. Metab., vol. 103, 1867, 10.1210/jc.2017-02149 Patel, 2018, Frailty and Outcomes After Myocardial Infarction: Insights From the CONCORDANCE Registry, J. Am. Heart Assoc., vol. 7, 10.1161/JAHA.118.009859 Peel, 2017, Frailty and adverse outcomes: impact of multiple bed moves for older inpatients, Int. Psychogeriatr., vol. 29, 345, 10.1017/S1041610216001605 Pelavski, 2017, Mortality, geriatric, and nongeriatric surgical risk factors among the eldest old: a prospective observational study, Anesth. Analg., vol. 125, 1329, 10.1213/ANE.0000000000002389 Perera, 2009, The impact of frailty on the utilisation of antithrombotic therapy in older patients with atrial fibrillation, Age Ageing, vol. 38, 156, 10.1093/ageing/afn293 Pollack, 2017, The Frailty Phenotype and Palliative Care Needs of Older Survivors of Critical Illness, J. Am. Geriatr. Soc. (JAGS), vol. 65, 1168, 10.1111/jgs.14799 Poudel, 2016, Adverse Outcomes in Relation to Polypharmacy in Robust and Frail Older Hospital Patients, J. Am. Med. Dir. Assoc., vol. 17, 767.e9, 10.1016/j.jamda.2016.05.017 Purser, 2006, Identifying frailty in hospitalized older adults with significant coronary artery disease, J. Am. Geriatr. Soc., vol. 54, 1674, 10.1111/j.1532-5415.2006.00914.x Ritt, 2015, Analysis of Rockwood et al.’s Clinical Frailty Scale and Fried et al.’s frailty phenotype as predictors of mortality and other clinical outcomes in older patients who were admitted to a geriatric ward. The, J. Nutr., Health Aging, vol. 19, 1043, 10.1007/s12603-015-0667-9 Rodriguez-Mañas, 2015, Frailty in the clinical scenario, Lancet, vol. 385, e7, 10.1016/S0140-6736(14)61595-6 Rose, 2014, Can frailty predict complicated care needs and length of stay?, Intern. Med. J., vol. 44, 800, 10.1111/imj.12502 Sánchez, 2011, Prevalence of geriatric syndromes and impact on clinical and functional outcomes in older patients with acute cardiac diseases, Heart (Br. Card. Soc. ), vol. 97, 1602, 10.1136/hrt.2011.227504 Sanchis, 2015, Usefulness of Clinical Data and Biomarkers for the Identification of Frailty After Acute Coronary Syndromes, Can. J. Cardiol., vol. 31, 1462, 10.1016/j.cjca.2015.07.737 Santos-Eggimann, 2009, Prevalence of Frailty in Middle-Aged and Older Community-Dwelling Europeans Living in 10 Countries, J. Gerontol. Ser. A, Biol. Sci. Med. Sci., vol. 64A, 675, 10.1093/gerona/glp012 Shamliyan, 2012, Association of frailty with survival: A systematic literature review, Ageing Res. Rev., vol. 12, 719, 10.1016/j.arr.2012.03.001 Sikder, 2019, Postoperative Recovery in Frail, Pre-frail, and Non-frail Elderly Patients Following Abdominal Surgery, World J. Surg., vol. 43, 415, 10.1007/s00268-018-4801-9 Siriwardhana, 2018, Prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries: a systematic review and meta-analysis, BMJ Open, vol. 8, 10.1136/bmjopen-2017-018195 Sourial, 2013, Implementing Frailty Into Clinical Practice: A Cautionary Tale, J. Gerontol. Ser. A, Biol. Sci. Med. Sci., vol. 68, 1505, 10.1093/gerona/glt053 Sternberg, 2011, The Identification of Frailty: A Systematic Literature Review, J. Am. Geriatr. Soc. (JAGS), vol. 59, 2129, 10.1111/j.1532-5415.2011.03597.x Sündermann, 2014, Frailty is a predictor of short- and mid-term mortality after elective cardiac surgery independently of age, Interact. Cardiovasc. Thorac. Surg., vol. 18, 580, 10.1093/icvts/ivu006 Taffett, 2003, Physiology of aging, 27 Tarazona-Santabalbina, 2016, A Multicomponent Exercise Intervention that Reverses Frailty and Improves Cognition, Emotion, and Social Networking in the Community-Dwelling Frail Elderly: A Randomized Clinical Trial, J. Am. Med. Dir. Assoc., vol. 17, 426, 10.1016/j.jamda.2016.01.019 Thai, 2015, Prevalence of potential and clinically relevant statin–drug interactions in frail and robust older inpatients, Drugs Aging, vol. 32, 849, 10.1007/s40266-015-0302-9 The Nordic Cochrane Centre, The Cochrane Collaboration, 2014, Review Manager (RevMan) [Computer program] (Version 5.3). Available: 〈https://training.cochrane.org/online-learning/core-software-cochrane-reviews/revman/revman-5-download〉. Theou, 2011, The effectiveness of exercise interventions for the management of frailty: a systematic review, J. Aging Res., vol. 2011, 10.4061/2011/569194 Theou, 2013, Exploring the relationship between national economic indicators and relative fitness and frailty in middle-aged and older Europeans, Age Ageing, vol. 42, 614, 10.1093/ageing/aft010 Theou, 2018, What do we know about frailty in the acute care setting? A scoping review, BMC Geriatr., vol. 18, 139, 10.1186/s12877-018-0823-2 Ticinesi, 2016, Lung ultrasound and chest x-ray for detecting pneumonia in an acute geriatric ward, Med. (Baltim. ), vol. 95 Timmons, 2015, Dementia in older people admitted to hospital: a regional multi-hospital observational study of prevalence, associations and case recognition, Age Ageing, vol. 44, 993, 10.1093/ageing/afv131 Valentini, 2018, Frailty and nutritional status in older people: the Mini Nutritional Assessment as a screening tool for the identification of frail subjects, Clin. Interv. Aging, vol. 13, 1237, 10.2147/CIA.S164174 Verlaan, 2017, High Prevalence of Physical Frailty Among Community-Dwelling Malnourished Older Adults–A Systematic Review and Meta-Analysis, J. Am. Med. Dir. Assoc., vol. 18, 374, 10.1016/j.jamda.2016.12.074 Vidán, 2014, FRAIL‐HF, a Study to Evaluate the Clinical Complexity of Heart Failure in Nondependent Older Patients: Rationale, Methods and Baseline Characteristics, Clin. Cardiol. (Mahwah, N. J. ), vol. 37, 725, 10.1002/clc.22345 Vollset, 2020, Fertility, mortality, migration, and population scenarios for 195 countries and territories from 2017 to 2100: a forecasting analysis for the Global Burden of Disease Study, Lancet (Br. Ed. ), vol. 396, 1285, 10.1016/S0140-6736(20)30677-2 Wallis, 2015, Association of the clinical frailty scale with hospital outcomes, QJM: Mon. J. Assoc. Physicians, vol. 108, 943, 10.1093/qjmed/hcv066 World Health Organisation, 2019, Global Health Expenditure Database (GHED). Available: 〈http://apps.who.int/nha/database/Home/Index/en〉. Downloaded: 02/05/2019. Wou, 2013, The predictive properties of frailty-rating scales in the acute medical unit, Age Ageing, vol. 42, 776, 10.1093/ageing/aft055 Xue, 2011, The frailty syndrome: definition and natural history, Clin. Geriatr. Med., vol. 27, 1, 10.1016/j.cger.2010.08.009