{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T21:08:40Z","timestamp":1788815320500,"version":"build-2803163510"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":35,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002803","name":"Fondazione Cariplo","doi-asserted-by":"publisher","award":["# 2023-0951"],"award-info":[{"award-number":["# 2023-0951"]}],"id":[{"id":"10.13039\/501100002803","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Detecting and measuring frailty is essential to inform health policy. Numerous frailty tools exist, but their application to population data remains limited. This study focuses on Italy and adopts a policymaker\u2019s perspective to identify practical, nationally applicable tools for bio-psycho-social frailty assessment using existing survey data. Three validated bio-psycho-social indicators\u2014the Tilburg Frailty Indicator (TFI), the Groningen Frailty Indicator (GFI), and the Edmonton Frail Scale (EFS)\u2014were operationalized across four population surveys (SHARE, EU-SILC, EHIS, and AVQ). The study proceeded in three steps: (i) reconstruction of each indicator within each dataset to assess items\u2019 replicability; (ii) validation of reproducible indicators by examining their psychometric properties; (iii) comparison of prevalence and predictive validity across indicators to illustrate their relative strengths and limitations. The GFI was the most replicable across surveys, while the EFS showed the strongest predictive ability. Among datasets, EHIS emerged as the most suitable platform, offering higher indicators\u2019 reproducibility and strong validity. Regional analyses revealed a clear North\u2013South gradient, and regression models confirmed that frailty adds explanatory power for health outcomes beyond chronological age and other sociodemographic characteristics. The study demonstrates that bio-psycho-social frailty can be measured using existing national surveys, providing a low-cost and reproducible framework for national monitoring. By highlighting the added value of frailty over age in predicting health needs, it lays the groundwork for integrating frailty assessment into public health planning and supporting more equitable and effective policy responses to population ageing.<\/jats:p>","DOI":"10.1093\/eurpub\/ckag120","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T04:48:07Z","timestamp":1784090887000},"source":"Crossref","is-referenced-by-count":0,"title":["Measuring bio-psycho-social frailty in older adults across multiple surveys and indicators: evidence from Italy for public health policy"],"prefix":"10.1093","volume":"36","author":[{"given":"Tommaso","family":"Aicardi","sequence":"first","affiliation":[{"name":"Department of Social and Political Sciences, Bocconi University , Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Listorti","sequence":"additional","affiliation":[{"name":"Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi, Bocconi University , Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Pongiglione","sequence":"additional","affiliation":[{"name":"Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi, Bocconi University , Milan,","place":["Italy"]},{"name":"Department of Political and Social Sciences, University of Pavia , Pavia,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"2026090716330322400_ckag120-B1","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.maturitas.2020.05.018","article-title":"The World Health Organization (WHO) approach to healthy ageing","volume":"139","author":"Rudnicka","year":"2020","journal-title":"Maturitas"},{"key":"2026090716330322400_ckag120-B2","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1016\/S0140-6736(12)62167-9","article-title":"Frailty in elderly people","volume":"381","author":"Clegg","year":"2013","journal-title":"Lancet"},{"key":"2026090716330322400_ckag120-B3","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1016\/S0140-6736(19)31786-6","article-title":"Frailty: implications for clinical practice and public health","volume":"394","author":"Hoogendijk","year":"2019","journal-title":"Lancet"},{"key":"2026090716330322400_ckag120-B4","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1016\/j.jamda.2016.05.013","article-title":"Frailty as a predictor of Alzheimer disease, vascular dementia, and all dementia among community-dwelling older people: a systematic review and meta-analysis","volume":"17","author":"Kojima","year":"2016","journal-title":"J Am Med Dir Assoc"},{"key":"2026090716330322400_ckag120-B5","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.jamda.2018.10.004","article-title":"Frailty as a predictor of emergency department utilization among community-dwelling older people: a systematic review and meta-analysis","volume":"20","author":"Kojima","year":"2019","journal-title":"J Am Med Dir Assoc"},{"key":"2026090716330322400_ckag120-B6","doi-asserted-by":"publisher","first-page":"100740","DOI":"10.1016\/j.lanhl.2025.100740","article-title":"Association between hospital frailty risk score and length of hospital stay, hospital mortality, and hospital costs for all adults in England: a nationally representative, retrospective, observational cohort study","volume":"6","author":"Street","year":"2025","journal-title":"Lancet Healthy Longev"},{"key":"2026090716330322400_ckag120-B7","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1177\/1355819617752971","article-title":"Moving upstream in health promoting policies for older people with early frailty in England? 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