FI-CGA and eFI-CGA in Frailty Care: a Scoping Review

Abstract

Background

Comprehensive geriatric assessment (CGA) is the reference standard for diagnosing and managing frailty. By evaluating a broad range of health, functional, cognitive, and social problems, the CGA enables the construction of a deficit accumulation Frailty Index (FI-CGA). Recent advances have integrated the electronic CGA (eCGA) into electronic health/medical records and other digital platforms, allowing auto-mated coding and summarization of CGA data to generate an electronic Frailty Index (eFI-CGA).

Methods

We reviewed over two decades of research on the develop-ment, validation, and application of the FI-CGA, eCGA, and eFI-CGA in health-care contexts, conducted following the PRISMA-ScR guidelines. A comprehensive search was performed in MEADLINE and CINAHL databases, including English language publications from 2004 to July 1, 2025. The 38 studies that met all criteria are included in the final review. Data were synthesized descriptively and analyzed thematically.

Results

The evidence suggests that the FI-CGA is a robust, adaptable predictor of adverse outcomes including mortality, hospitalization, and functional decline. Digital adaptations improve feasibility, accuracy, and workflow, supporting wider application in acute, long-term, primary, and community care. The transition from manual to eCGA-based frailty measurements marks a significant advance toward scalable, integrated frailty care. Emerging implementations are targeting earlier detection, risk stratification, and personalized interventions.

Conclusion

The digital eCGA and eFI-CGA tools hold potential to enhance (“geriatrize”) capacity to identify and manage frailty across care settings. Further research is needed to validate them across populations, and leverage innovative technologies to advance frailty care, in these ways promoting healthy aging.