Sys Rev Pharm 2020;11(3):842-846 A multifaceted review journal in the field of pharmacy 842 Systematic Reviews in Pharmacy Vol 11, Issue 3, Mar-Apr 2020 Diagnostic Test of Frailty Syndrome Based on Scoring Systems of Cardiovascular Health Study (CHS), Study of Osteoporotic Fracture (SOF), and Tilburg Frailty Indicator (TFI) to Frailty Index Based on Comprehensive Geriatric Assessment (FI-CGA) Rastita Widyasari 1 , Novira Widajanti 2 , Jusri Ichwani 2 1 Departement of Internal Medicine, Faculty of Medicine-Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya 60131, Indonesia 2 Geriatric Division, Departement of Internal Medicine, Faculty of Medicine-Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya 60131, Indonesia , Corresponding Author :Novira Widajanti,Email: novirawidajanti@yahoo.com Geriatric Division, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60131, Indonesia ABSTRACT The Cardiovascular Health Study (CHS), Study of Osteoporotic Fracture (SOF), and Tilburg Frailty Indicator (TFI) scoring systems are known to be more applicable than Frailty Index Based on Comprehensive Geriatric Assessment (FI-CGA) in community health services but their diagnostic capabilities have not been known. The objective of this study was to find out the diagnostic test of frailty syndrome based on CHS, SOF, and TFI to FI-CGA scoring system in Surabaya elderly community. This study was a cross-sectional analytic study with diagnostic test approach that is calculating sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and ROC curve of CHS, SOF, and TFI to FI-CGA scoring system as reference standard. A total of 170 females and males aged >60 years who were enrolled in elderly health center in this study. To classify frail and non- frail conditions, CHS had 78.57% sensitivity, 71.8% specificity, and AUC value of 0.802 (CI=95%, p<0.001), SOF had 23.8% sensitivity, 87.5% specificity, and AUC value of 0.739 (CI=95%, p<0.001), TFI had 71.43% sensitivity, 78.13% specificity, and AUC value of 0.859 (CI=95%, p<0.001). CHS and TFI have a good diagnostic capability to diagnose frailty syndrome in health center for elderly in Surabaya. Keywords: frailty; elderly; CHS; SOF; TFI; FI-CGA Correspondance: Novira Widajanti 2 2 Geriatric Division, Departement of Internal Medicine, Faculty of Medicine-Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya 60131, Indonesia. Email: novirawidajanti@yahoo.com INTRODUCTION In the elderly, health problems come from declining body cells, so the function and body endurance decreased along with increased risk factors for diseases and infections.[1], [2] Health status is divided into 3 in elderly, there are fit/robust, pre-frailty, and frailty. An elderly person is regarded fit/robust when the cell homeostatic reserve exceeds the number of the deficits, pre-frailty (latent and reversible clinical phase) when physiological reserves are sufficient to respond to stressors, while frailty when body physiological reserves and cell homeostasis are reduced, resilience against stressors decreased, and increased susceptibility to illness, hospitalization and death.[3]–[5] Besides, the elderly person is susceptible to memory loss and especially in women will experience menopause which can cause depression.[6], [7] One of the most common causes of disability and death in elderly is frailty syndrome.[3] Frailty syndrome is associated with an increased risk of death, falls, hospitalization, decreased functional capacity, and disability.[8]–[11] However, frailty syndrome is known to have dynamic properties so that it can be prevented and restored.[12], [13] The problem is, until now there is no guidance on simple measuring tools for the diagnosis of frailty syndrome, especially in community health services.[10] Diagnostic measuring tools for frailty syndrome were developed as a scoring system with the aim of accommodating multidimensional factors of frailty. According to the calculated variables, the frailty syndrome diagnosis scoring system is classified into 3 models, phenotypic model such as Cardiovascular Health Study (CHS) and Study of Osteoporotic Fracture (SOF), multidimensional model such as Tilburg Frailty Indicator (TFI), and deficit accumulation model such as Frailty Index 40 item (FI-40) and Frailty Index based on Comprehensive Geriatric Assessment (FI-CGA).[8], [14] The FI-40 scoring system began to be developed in 2001 by Rockwood and Mitnitski and it is widely regarded as the gold standard for measuring frailty syndrome. However, FI-40 has limitations to use in community health services because it, for example, requires special measuring devices (spirometer and dynamometer), trained examiners, and takes a long time to process for 20-30 minutes.[14], [15] Compared to FI-40, FI-CGA is easier and shorter because it does not require special tools.[8], [16] The FI-CGA system is one of the best measuring tools for diagnosing frailty syndrome because it includes physical,