Table 2 FOCUS guideline questions in the PICO format

GQ – Should interventions to prevent or delay the progression of frailty, or to reverse frailty, be adopted in prefrail or frail older people?

Q1 – Should physical interventions be recommended to prevent or delay the progression of frailty, or to reverse frailty, in prefrail or frail older people?

Q2 – Should interventions based on tailored care and/or GEM be recommended to prevent or delay the progression of frailty, or to reverse frailty, in prefrail or frail older people?

Q3 – Should other interventions be recommended to prevent or delay the progression of frailty, or to reverse frailty, in prefrail or frail older people?

Patients: People aged 65 years or older, defined as prefrail or frail according to a pre-specified scale, index or criteria, not at the end-of-life phase or selected because of an index disease

Interventions:

GQ: Any intervention explicitly defined as an intervention for frailty (regardless of the definition of frailty used)

Q1: Physical interventions

 • Interventions based on exercise/physical activity

 • Nutritional interventions (e.g. diet change, supplementation)

 • Exercise/physical activity combined with nutritional interventions

Q2: Interventions based on tailored care and/or GEM

 • Uni-professional interventions based on tailored care/GEM

 • Multidisciplinary interventions based on tailored care/GEM

Q3: Other interventions^a

 • Cognitive training

 • A composite of exercise + nutritional supplementation + cognitive training

 • Exercise + nutritional consultation

 • Problem-solving therapy

 • Hormone therapy

 • Others

Reference intervention: No intervention or placebo or usual care

Outcomes:

 • Frailty – defined according to a composite index, or based on physical performance tests commonly related to the ‘frailty’ definition (SPPB, TUG, gait speed, handgrip strength)

 • Other relevant patient important outcomes – cognitive performance, functional performance, other measures of physical performance, quality of life, depression, self-perceived health, social engagement, caregiver burden, falls and fractures, mortality, hospitalisation, institutionalisation, comorbidity burden, drug prescription

Setting: Any (community, primary care, nursing homes, hospitals)

Perspective: Population