{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:53:53Z","timestamp":1790927633402,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Healthcare systems in low\u2010 and middle\u2010income countries are under pressure to adapt services for ageing populations, and frailty screening has gained interest as a means of identifying older adults at risk of adverse outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The aim of this study was to examine two frailty instruments for the prediction of mortality in older adults admitted to hospital in Tanzania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study followed 308 people, aged \u2265\u200960 years, admitted to four hospitals in the Kilimanjaro Region between March and August 2022. Baseline frailty was assessed using the Clinical Frailty Scale (CFS) and the Brief Frailty Instrument for Tanzania (B\u2010FIT). The primary outcome was all\u2010cause mortality, with secondary outcomes of length of stay and change in functional status. Cox regression estimated hazard ratios (HRs) for mortality, with Harrell's C statistic and receiver operator characteristics used to compare instrument performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Follow\u2010up data were available for 194 participants (63%). After a mean of 10.8 months of follow\u2010up, adjusted models demonstrated frailty was associated with higher mortality (CFS HR 2.26, 95% CI 1.34\u20133.83; B\u2010FIT HR 2.63, 95% CI 1.45\u20134.77,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). The two instruments showed similar discriminatory power. Neither was associated with length of stay. Among survivors, frailty was associated with decline in physical function, but not social function.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Frailty screening, using either the CFS or B\u2010FIT, offered a feasible method for identifying older adults at the greatest risk of adverse outcomes. Such tools should be investigated as a means of targeting limited resources towards the most vulnerable older adults in an African setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.72974","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T07:10:46Z","timestamp":1786950646000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparing Two Frailty Tools for the Prediction of Mortality in Older People Admitted to Hospital in Tanzania: A Prospective Cohort Study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4072-0072","authenticated-orcid":false,"given":"Sean L.","family":"Davidson","sequence":"first","affiliation":[{"name":"University of Otago, Dunedin Otago New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amie","family":"Murray","sequence":"additional","affiliation":[{"name":"Newcastle University Newcastle upon Tyne Tyne and Wear UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Hardy","sequence":"additional","affiliation":[{"name":"Newcastle University Newcastle upon Tyne Tyne and Wear UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theo","family":"Randall","sequence":"additional","affiliation":[{"name":"Newcastle University Newcastle upon Tyne Tyne and Wear UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Godrule","family":"Lyimo","sequence":"additional","affiliation":[{"name":"Kilimanjaro Christian Medical Centre Moshi Kilimanjaro Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph K.","family":"Trinitas","sequence":"additional","affiliation":[{"name":"School of Nursing KCMC University Moshi Kilimanjaro Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Rayers","sequence":"additional","affiliation":[{"name":"Newcastle University Newcastle upon Tyne Tyne and Wear UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Bickerstaff","sequence":"additional","affiliation":[{"name":"Newcastle University Newcastle upon Tyne Tyne and Wear UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Emmence","sequence":"additional","affiliation":[{"name":"Newcastle University Newcastle upon Tyne Tyne and Wear UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara\u2010May Motraghi","family":"Nobes","sequence":"additional","affiliation":[{"name":"Newcastle University Newcastle upon Tyne Tyne and Wear UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Chuwa","sequence":"additional","affiliation":[{"name":"Mawenzi Regional Referral Hospital Moshi Kilimanjaro Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fortunatus","family":"Kisheo","sequence":"additional","affiliation":[{"name":"Hai District Hospital Boma Ng'ombe Kilimanjaro Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elibariki","family":"Kisaruni","sequence":"additional","affiliation":[{"name":"Machame Lutheran Hospital Machame Kilimanjaro Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Mitchell","sequence":"additional","affiliation":[{"name":"North Bristol NHS Foundation Trust Bristol City and County of Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2590-7082","authenticated-orcid":false,"given":"Sarah","family":"Urasa","sequence":"additional","affiliation":[{"name":"Kilimanjaro Christian Medical Centre Moshi Kilimanjaro Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard W.","family":"Walker","sequence":"additional","affiliation":[{"name":"Newcastle University Newcastle upon Tyne Tyne and Wear UK"},{"name":"Northumbria Healthcare NHS Foundation Trust Newcastle upon Tyne Tyne and Wear UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine L.","family":"Dotchin","sequence":"additional","affiliation":[{"name":"Newcastle University Newcastle upon Tyne Tyne and Wear UK"},{"name":"Northumbria Healthcare NHS Foundation Trust Newcastle upon Tyne Tyne and Wear UK"},{"name":"AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences Newcastle University Newcastle upon Tyne UK"},{"name":"NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Cumbria Northumberland Tyne and Wear NHS Foundation Trust and Faculty of Medical Sciences Newcastle University Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"World Report on Ageing and Health","author":"World Health Organization","year":"2015"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)62167-9"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2016.09.010"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2019.100960"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.101947"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-018195"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2022.101666"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afae279"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-019-1273-z"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afu138"},{"key":"e_1_2_11_12_1","article-title":"Comprehensive Geriatric Assessment for Older Adults Admitted to Hospital","volume":"9","author":"Ellis G.","year":"2017","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.4314\/gmj.v53i3.5"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-024-04789-6"},{"key":"e_1_2_11_15_1","unstructured":"World Health Organization. Decade of Healthy Ageing: Baseline Report. Geneva;2020."},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-020-01801-7"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.050051"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15433"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1590\/1981-22562021024.210122"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17051582"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S243211"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S225149"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/0361073X.2017.1298957"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-019-01406-0"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.4314\/thrb.v19i2.8"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0254131"},{"key":"e_1_2_11_27_1","first-page":"61","article-title":"Functional Evaluation: The Barthel Index","volume":"14","author":"Mahoney F. I.","year":"1965","journal-title":"Maryland State Medical Journal"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.3402\/gha.v7.25988"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638288809164103"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-018-0967-0"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7280.226"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2012.03080.x"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.143.1.7063747"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0213131"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.2019.v109i2.13275"},{"key":"e_1_2_11_36_1","first-page":"36","article-title":"In\u2010Hospital Elderly Mortality in a Nigerian Tertiary Health Care Center","volume":"6","author":"Obiora U. J.","year":"2020","journal-title":"Elderly Health Journal"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0205833"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-020-01907-y"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.983"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afs119"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-015-0378-4"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.enfcle.2019.03.005"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.12827"},{"key":"e_1_2_11_44_1","first-page":"2050","article-title":"Social Vulnerability, Frailty, and Their Association With Mortality in Older Adults Living in Rural Tanzania","volume":"77","author":"Cooper F.","year":"2022","journal-title":"Journals of Gerontology"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol31110517"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjment-2025-301733"},{"key":"e_1_2_11_47_1","volume-title":"Universal Health Coverage in Low\u2010Income Countries: Tanzania's Efforts to Overcome Barriers to Equitable Health Service Access","author":"Wang H.","year":"2018"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-023-01855-0"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2020.1841962"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/0277-9536(94)90226-7"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.afjem.2023.06.007"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0004032"}],"container-title":["Health Science Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.72974","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hsr2.72974","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.72974","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:09:02Z","timestamp":1790924942000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hsr2.72974"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":51,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/hsr2.72974"],"URL":"https:\/\/doi.org\/10.1002\/hsr2.72974","archive":["Portico"],"relation":{},"ISSN":["2398-8835","2398-8835"],"issn-type":[{"value":"2398-8835","type":"print"},{"value":"2398-8835","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2025-12-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72974"}}