Frailty Screening in Low- and Middle-Income Countries: A Systematic Review.
OBJECTIVE
To conduct a systematic review of frailty screening tools used in low- and middle-income countries (LMICs).


METHODS
Systematic review.


METHODS
LMICs, as defined by the World Bank on June 30, 2014.


METHODS
Elderly adults (as defined by the authors) living in LMICs.


METHODS
Studies were included if the population under consideration lived in a LMIC, the study involved an assessment of frailty, the study population was elderly adults, and the full text of the study was available in English. The Medline, Embase, CINAHL and PsychINFO databases were searched up to June 30, 2014.


RESULTS
Seventy studies with data from 22 LMICs were included in the review. Brazil, Mexico, and China provided data for 60 of the 70 studies (85.7%), and 15 countries contributed data to only one study. Thirty-six studies used the Fried criteria to assess frailty, 20 used a Frailty Index, and eight used the Edmonton Frailty Scale; none of the assessment tools used had been fully validated for use in a LMIC.


CONCLUSIONS
There has been a rapid increase in the number of published studies of frailty in LMICs over the last 5 years. Further validation of the assessment tools used to identify frail elderly people in LMICs is needed if they are to be efficient in identifying those most in need of health care in such settings.
Northumbria Healthcare National Health Service Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom.
William K
WK
Gray
Northumbria Healthcare National Health Service Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom.
Jenny
J
Richardson
Northumbria Healthcare National Health Service Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom.
Jackie
J
McGuire
Health Education North East, Newcastle Upon Tyne, United Kingdom.
Felicity
F
Dewhurst
Northumbria Healthcare National Health Service Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom.
Vasanthi
V
Elder
Northumbria Healthcare National Health Service Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom.
Julie
J
Weeks
Northumbria Healthcare National Health Service Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom.|Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom.
Richard W
RW
Walker
Northumbria Healthcare National Health Service Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom.|Institute for Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom.
Catherine L
CL
Dotchin
D000368:Aged; D000369:Aged, 80 and over; D003906:Developing Countries; D016330:Frail Elderly; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006801:Humans
cognitive impairment; disability; elderly; frailty; low- and middle-income country; systematic review