Background: Frailty is associated with adverse outcomes in older adults across healthcare settings. Frailty screening tools can serve to identify older adults living with frailty and direct resources to high-risk older adults. This systematic review and meta-analysis examined the diagnostic and predictive accuracy of the Program of Research to Integrate the Services for the Maintenance of Autonomy 7 (PRISMA-7) frailty screening tool.

Methods: A systematic literature search was conducted in PubMed, EMBASE, CINAHL, EBSCO and the Cochrane Library. Prospective or retrospective cohort and cross-sectional studies that explored the diagnostic and/or predictive accuracy of the PRISMA-7 tool in older adults were included across all healthcare settings. Study quality was assessed using the QUADAS-2 tool. Statistical analysis was completed using Stata version 12 (StataCorp, TX, USA). A bivariate random effects model was used to generate pooled estimates of sensitivity and specificity. RevMan5 was used to pool data comparing older adults living with frailty versus those without frailty.

Results: Thirty-six studies were included in the review. The overall quality of the studies included was moderate. Meta-analysis of diagnostic accuracy (regardless of reference standard used) showed a pooled sensitivity and specificity of 72% (95% CI 54-84%) and 87% (95% CI 76-93%), respectively. Sub-analysis of the six studies that used Frailty Phenotype as a reference standard demonstrated pooled sensitivity and specificity of 82% (95% CI 73.8-88.2) and 79% (95% CI 72-85.6%), respectively. Meta-analysis of the predictive accuracy of the PRISMA-7 showed that older adults living with frailty spent significantly more time in the emergency department (FEM MD 2.66 h, 95% CI 2.15-3.16 h, I² = 25%) and stayed longer in hospital, (REM MD 1.89 days, 95% CI 0.18-3.6 days, I² = 86%), respectively.

Conclusion: The PRISMA-7 has a moderate sensitivity and high specificity for frailty identification. It has good predictive accuracy for multiple adverse outcomes among older adults, supporting its potential utilization across healthcare settings.

Keywords: Frailty; Older adults; PRISMA-7; Screening.

© 2025. The Author(s).

背景： 脆弱性与老年人在各种医疗保健环境中的不良结果相关。脆弱性筛查工具可以用于识别患有脆弱性的老年人，并将资源导向高风险的老年人群。本系统评价和元分析研究了Program of Research to Integrate the Services for the Maintenance of Autonomy 7 (PRISMA-7) 脆弱性筛查工具的诊断和预测准确性。

方法： 在PubMed、EMBASE、CINAHL、EBSCO 和 Cochrane Library 中进行了系统文献检索。纳入了所有医疗保健环境中的前瞻性或回顾性队列研究和横断面研究，这些研究探讨了PRISMA-7 工具在老年人群中的诊断和/或预测准确性。使用QUADAS-2 工具评估了研究质量。统计分析使用的是Stata 软件版本12（StataCorp, TX, USA）。采用二元随机效应模型生成敏感性和特异性的汇总估计值。RevMan5 用于比较患有脆弱性老年人与未患脆弱性老年人的数据。

结果： 共纳入了36 篇研究文献，总体质量中等。诊断准确性元分析（无论采用何种参考标准）显示汇总敏感性和特异性分别为72% (95% CI 54-84%) 和87% (95% CI 76-93%)。使用脆弱性表型作为参考标准的六项研究子分析表明，汇总敏感性和特异性分别为82% (95% CI 73.8-88.2) 和79% (95% CI 72-85.6)。PRISMA-7 的预测准确性元分析显示，患有脆弱性的老年人在急诊室的时间显著更长（FEM MD 2.66 h, 95% CI 2.15-3.16 h, I² = 25%)，住院时间也更长 (REM MD 1.89 days, 95% CI 0.18-3.6 days, I² = 86%)。

结论： PRISMA-7 在脆弱性识别中具有中等敏感性和高特异性。它对老年人群中的多种不良结果有良好的预测准确性，支持其在各种医疗保健环境中的潜在应用。

关键词： 脆弱性；老年人；PRISMA-7；筛查。