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Comparing clinician descriptions of frailty and geriatric syndromes using electronic health records: a retrospective cohort study
Laura J. Anzaldi, Ashwini Davison, Cynthia M. Boyd, Bruce A. Leff, Hadi H.K. Kharrazi. BMC Geriatrics, 2017-10-25
Topic: Risk, prevention and care in population studies
Of the 18,341 patients, we found that 2202 (12%) were described as "frail" in clinical notes. "Frail" patients were older (82.3 ± 6.8 vs 75.9 ± 5.9, p < .001) and had higher rates of healthcare utilization, including number of inpatient hospitalizations and emergency department visits, than the rest of the population (p < .001). "Frail" patients had on average 4.85 ± 1.72 of the ten geriatric syndromes studied, while non-frail patients had 2.35 ± 1.71 (p = .013). Falls, walking difficulty, malnutrition, weight loss, lack of social support and dementia were more highly correlated with frailty descriptions. The most common geriatric syndrome pattern among "frail" patients was a combination of walking difficulty, lack of social support, falls, and weight loss. Patients identified as "frail" by providers in clinical notes have higher rates of healthcare utilization and more geriatric syndromes than other patients. Certain geriatric syndromes were more highly correlated with descriptions of frailty than others.
Key findings
- Of the 18,341 patients, we found that 2202 (12%) were described as "frail" in clinical notes. "Frail" patients were older (82.3 ± 6.8 vs 75.9 ± 5.9, p < .001) and had higher rates of healthcare utilization, including number of inpatient hospitalizations and emergency department visits, than the rest of the population (p < .001). "Frail" patients had on average 4.85 ± 1.72 of the ten geriatric syndromes studied, while non-frail patients had 2.35 ± 1.71 (p = .013).
- Falls, walking difficulty, malnutrition, weight loss, lack of social support and dementia were more highly correlated with frailty descriptions.
- The most common geriatric syndrome pattern among "frail" patients was a combination of walking difficulty, lack of social support, falls, and weight loss.
- Patients identified as "frail" by providers in clinical notes have higher rates of healthcare utilization and more geriatric syndromes than other patients.
- Certain geriatric syndromes were more highly correlated with descriptions of frailty than others.
Why it matters
This study looked at how often doctors described patients as 'frail' in their notes and which geriatric conditions went along with that description, including dementia. It does not test any treatment, cure, or prevention of Alzheimer's disease.
Study details
- Study designcohort study
- Participants18,341
- Evidence strengthModerate
How this study scored 58/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (BMC Geriatrics) |
| Journal's citation record | 2 / 4 | BMC Geriatrics: journal h-index 153 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2017 — within 10 year(s) of the newest study here |
| Sample size | 4 / 4 | 18,341 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 80 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 7.3 citations a year over 11 year(s) since 2017 |
| Impact for its field and year | 3 / 6 | Cited 4.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 2 / 4 | Cited 19 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Hadi H.K. Kharrazi: h-index 40 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Johns Hopkins University: institution h-index 2,306 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 29070036) |
| Free to read | 2 / 2 | Free to read |
| Total | 58 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Anzaldi, L. J., Davison, A., Boyd, C. M., Leff, B. A., & Kharrazi, H. H. (2017). Comparing clinician descriptions of frailty and geriatric syndromes using electronic health records: a retrospective cohort study. BMC Geriatrics. https://doi.org/10.1186/s12877-017-0645-7
Vancouver
Anzaldi LJ, Davison A, Boyd CM, Leff BA, Kharrazi HH. Comparing clinician descriptions of frailty and geriatric syndromes using electronic health records: a retrospective cohort study. BMC Geriatrics. 2017. doi:10.1186/s12877-017-0645-7. PMID: 29070036.
BibTeX
@article{anzaldi2017-29070036,
author = {Anzaldi, Laura J. and Davison, Ashwini and Boyd, Cynthia M. and Leff, Bruce A. and Kharrazi, Hadi H.K.},
title = {{Comparing clinician descriptions of frailty and geriatric syndromes using electronic health records: a retrospective cohort study}},
journal = {BMC Geriatrics},
year = {2017},
doi = {10.1186/s12877-017-0645-7},
pmid = {29070036},
url = {https://doi.org/10.1186/s12877-017-0645-7}
}
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