57 A review of the utilisation of the SHARE frailty instruments (SHARE-FI and SHARE-Fi75+) in the literature

Abstract

Abstract Background The Survey of Health, Ageing and Retirement in Europe (SHARE) frailty instruments SHARE-FI and SHARE-FI75+ were developed as non-commercial, open access frailty phenotype-based identification tools for rapid use in the primary care setting. This literature review examined their utilisation since their publication. Methods We used the Google Scholar ‘cited by’ function (accessed on February 20th, 2023) to identify all citations of the original SHARE-FI and SHARE-FI75+ studies. Included articles were categorised into four themes: epidemiological studies (prevalence and associated factors); associations with geriatric syndromes, diseases and health outcomes; randomised clinical trials (RCTs); and expert consensus and practice guidelines. Results Of 529 articles screened (446 citing SHARE-FI and 83 citing SHARE-FI75+), 64 (12.1%) were included in the narrative review. Sixteen (25.0%) were epidemiological; 35 (54.7%) described associations; 10 (15.6%) were RCTs; and 3 (4.7%) were expert consensus or practice guidelines. Frailty was associated with older age; female sex; higher morbidity; lower education; social isolation; worse nutrition and mobility; rheumatological, cardiovascular, and endocrine diseases; and greater healthcare utilisation and mortality. SHARE-FI was used in RCTs as entry criterion, controlling variable and intervention outcome. The most commonly studied interventions were exercise, nutrition and social support. SHARE-FI and SHARE-FI75+ have been recommended to aid the management of atrial fibrillation anticoagulation (2015 European Heart Rhythm Association (EHRA) Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation) and hypertension (2016 Expert Opinion From the European Society of Hypertension-European Union Geriatric Medicine Society Working Group on the Management of Hypertension in Very Old, Frail Subjects), respectively. Conclusion SHARE-FI and SHARE-FI75+, two open access phenotypical frailty measurement tools, have been utilised for diverse purposes, and mostly in epidemiological/associational studies. The relative paucity of RCTs and guidelines vis-à-vis epidemiological and associational studies highlights scope for their future utilisation in studies that will be able to generate higher-level evidence.