Measurement tools for social frailty in cancer patients: A systematic review.

PURPOSE: Assessing social frailty in cancer care is crucial because a patient's support, resources, and social stability can determine whether they can receive, tolerate, and complete treatment, ultimately influencing their outcomes and quality of life. This review aimed to identify and describe instruments used to assess social frailty in adult cancer populations, and to summarise their key characteristics and measurement features.

METHODS

In this systematic review, six electronic databases including PubMed, Embase, PsycINFO, CINAHL, Cochrane Library, and Web of Science were searched and the PRISMA reporting guidelines was followed. Eligible studies included adults with cancer in whom social frailty was assessed using a standardised instrument or a multidomain frailty tool with a social frailty component. Study quality was appraised using JBI tools. Because of remarkable heterogeneity among studies, narrative synthesis was used.

RESULTS

In total, 64 studies were included. Nine instruments were identified: HALFT, Makizako Social Frailty Index, Social Support Rating Scale, Groningen Frailty Indicator, Tilburg Frailty Indicator, Comprehensive Frailty Assessment Instrument, Carolina Frailty Index, Edmonton Frailty Scale, and the 10-item CGA Frailty Index. These tools differed widely in conceptual focus, item content, scoring ranges, and cut-off values. Most were originally developed for community-dwelling older adults or other non-oncology groups, and cancer-specific psychometric validation was limited. Reported reliability in cancer populations was often only questionable to acceptable.

CONCLUSIONS

Social frailty is an important but inconsistently measured domain in oncology. Current instruments for social frailty measurement are diverse, only partly validated and reported for cancer populations, and not directly comparable.