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Frailty was assessed using the following: Frailty Phenotype, SHARE\u2010FI, 5\u2010item Frailty Trait Scale (FTS\u20105), 3\u2010item FTS (FTS\u20103), FRAIL scale, 35\u2010item Frailty Index (FI\u201035), G\u00e9rontop\u00f4le Frailty Screening Tool, and Clinical Frailty Scale. Adverse outcomes ascertained at follow\u2010up were as follows: falls, hospitalization, increase in limitation in basic (BADL) and instrumental activities of daily living (IADL), and mortality. Sensitivity, specificity, and capacity to predict adverse outcomes in logistic regressions by each instrument above age, gender, and multimorbidity were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 996 individuals were followed (mean age 82.2 SD 5.5\u00a0years, 61.3% female). In geriatric wards, the FI\u201035 (69.1%) and the FTS\u20105 (67.9%) showed good sensitivity to predict death and good specificity to predict BADL worsening (70.3% and 69.8%, respectively). The FI\u201035 also showed good sensitivity to predict BADL worsening (74.6%). In nursing homes, the FI\u201035 and the FTSs predicted mortality and BADL worsening with a sensitivity\u00a0&gt;\u00a073.9%. In geriatric clinic, the FI\u201035, the FTS\u20105, and the FRAIL scale obtained specificities\u00a0&gt;\u00a085% to predict BADL worsening. No instrument achieved high enough sensitivity nor specificity in primary care. All the instruments predict the risk for all the outcomes in the whole sample after adjusting for age, gender, and multimorbidity. The associations of these instruments that remained significant by setting were for BADL worsening in geriatric wards [FI\u201035 OR\u00a0=\u00a05.94 (2.69\u201313.14), FTS\u20103\u00a0=\u00a03.87 (1.76\u20138.48)], nursing homes [FI\u201035\u00a0=\u00a04.88 (1.54\u201315.44), FTS\u20105\u00a0=\u00a03.20 (1.61\u20136.38), FTS\u20103\u00a0=\u00a02.31 (1.27\u20134.21), FRAIL scale\u00a0=\u00a01.91 (1.05\u20133.48)], and geriatric clinic [FRAIL scale\u00a0=\u00a04.48 (1.73\u201311.58), FI\u201035\u00a0=\u00a03.30 (1.55\u20137.00)]; for IADL worsening in primary care [FTS\u20105\u00a0=\u00a03.99 (1.14\u201313.89)] and geriatric clinic [FI\u201035\u00a0=\u00a03.42 (1.56\u20137.49), FRAIL scale\u00a0=\u00a03.27 (1.21\u20138.86)]; for hospitalizations in primary care [FI\u201035\u00a0=\u00a03.04 (1.25\u20137.39)]; and for falls in geriatric clinic [FI\u201035\u00a0=\u00a02.21 (1.01\u20134.84)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>No single assessment instrument performs the best for all settings and outcomes. While in inpatients several commonly used frailty instruments showed good sensitivities (mainly for mortality and BADL worsening) but usually poor specificities, the contrary happened in geriatric clinic. None of the instruments showed a good performance in primary care. The FI\u201035 and the FTS\u20105 showed the best profile among the instruments assessed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12990","type":"journal-article","created":{"date-parts":[[2022,4,16]],"date-time":"2022-04-16T06:38:58Z","timestamp":1650091138000},"page":"1487-1501","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["The ability of eight frailty instruments to identify adverse outcomes across different settings: the FRAILTOOLS project"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3785-1821","authenticated-orcid":false,"given":"Myriam","family":"Oviedo\u2010Briones","sequence":"first","affiliation":[{"name":"Fundaci\u00f3n para la Investigaci\u00f3n Biom\u00e9dica del Hospital Universitario de Getafe  Madrid Spain"},{"name":"Facultad de Medicina Universidad de las Am\u00e9ricas  Quito 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