title: Identifying frailty in primary care: A systematic review.
abstract: OBJECTIVE
  Identification of frailty in the primary care setting could be improved with the availability of easily identifiable markers of frailty. The purpose of this article was to systematically review markers for frailty or risk tools that have been validated in the ambulatory care setting.
  
  
  METHODS
  Medline, PubMed, CIHAHL and Embase databases were searched up to March 2016 for studies on frailty markers in community-dwelling individuals 65 years or older. Studies were included for review if they were carried out in primary care or outpatient settings, used a validated definition of frailty, compared two or more markers, and used randomized controlled trial, quasi-experimental or prospective cohort designs.
  
  
  RESULTS
  Of the 3405 titles screened, 12 were retained for review. All of the studies were prospective cohort designs. Studies most frequently assessed biological markers, such as immune, inflammation, endocrine biomarkers and metabolic syndrome markers. Not one specific marker was repeatedly identified as a definitive marker for frailty.
  
  
  CONCLUSIONS
  There is a lack of psychometrically sound and clinically useful frailty markers. There is a need for further research to identify highly sensitive, specific and accurate markers that are feasible to use in the context of busy primary care practice. Geriatr Gerontol Int 2017; 17: 1358-1377.
authors.affiliation: Center for Family Medicine Family Health Team, Kitchener, Ontario, Canada.|Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.|Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario, Canada.
authors.forename: Linda
authors.initials: L
authors.lastname: Lee
authors.affiliation: Center for Family Medicine Family Health Team, Kitchener, Ontario, Canada.|Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.|University of Waterloo School of Pharmacy, Waterloo, Ontario, Canada.
authors.forename: Tejal
authors.initials: T
authors.lastname: Patel
authors.affiliation: St. Joseph's Health Care, London, Ontario, Canada.|Aging, Rehabilitation and Geriatric Care Research Center of the Lawson Health Research Institute, London, Ontario, Canada.
authors.forename: Loretta M
authors.initials: LM
authors.lastname: Hillier
authors.affiliation: Center for Family Medicine Family Health Team, Kitchener, Ontario, Canada.
authors.forename: Niraj
authors.initials: N
authors.lastname: Maulkhan
authors.affiliation: Center for Family Medicine Family Health Team, Kitchener, Ontario, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Slonim
authors.affiliation: Departments of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Costa
mesh_terms: D000368:Aged; D016208:Databases, Factual; D016330:Frail Elderly / Q000706:statistics & numerical data*; D000073496:Frailty / Q000175:diagnosis*; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D011320:Primary Health Care; D011594:Psychometrics / Q000379:methods*
keywords: frailty; frailty markers; primary care