Frailty and quality of life in older ICU survivors: a scoping review of assessment tools and methodologies

Abstract Background Life expectancy increases, leading to growth in an older population where frailty and comorbidities are more prevalent. Subsequent increased intensive care unit (ICU) treatment results in prolonged rehabilitation and post-discharge loss of physiological and intellectual functions, negatively influencing quality of life (QoL). Methods This scoping review aims to identify existing research on assessment methods for frailty, QoL, and health-related outcomes for these ICU survivors. The review followed Joanna Briggs Institute guidelines for scoping reviews and reported using the PRISMA-P checklist. Systematic searches were conducted in Embase, Medline, PsycINFO, and CINAHL (2013 to 2023). Included studies were primary, peer-reviewed, or empirical studies written in English or Scandinavian, patients aged 70+, admitted to ICU more than 48 h, and inclusion of both frailty and QoL. A librarian qualified the search. Two reviewers independently screened articles and extracted data; a third reviewer resolved discrepancies. Results A total of 5,198 articles were identified. Nine met the eligibility criteria. Different tools assessed frailty and QoL. For frailty, Clinical Frailty Scale, Karnofsky Performance Status, Modified Katz Index of Activities of Daily Living, Groningen Frailty Indicator, CGA questionnaire, or Barthel Index were used. A combination of scales (SF-12, SF-36, EQ-5D, EQ-5D-5 L, or EQ-5D-3 L), questionnaires, or interviews (regarding residential and functional status and self-reported health-related QoL) was used for QoL. Conclusion Frail older ICU survivors experience persistent physical, cognitive, and symptom-related challenges poorly captured by conventional QoL assessments, particularly regarding psychological and subjective experiences. The few studies addressing both frailty and QoL make it difficult to establish evidence, highlighting the need for standardised, multidimensional, patient-centred frameworks. Trial registration Not applicable.