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Measuring frailty using claims data for pharmacoepidemiologic studies of mortality in older adults: evidence and recommendations

Geriatric frailty is a common syndrome of older adults that is characterized by increased vulnerability to adverse health outcomes and influences treatment choice. Pharmacoepidemiologic studies that rely on administrative claims data in older adults are limited by confounding due to unmeasured frailty. A claims‐based frailty score may be useful to minimize confounding by frailty in such databases. We provide an overview of definitions and measurement of frailty, evaluated the claims‐based models of frailty in literature, and recommend ways to improve frailty adjustment in claims analysis.