Characterization of Models for Identifying Physical and Cognitive Frailty in Older Adults With Diabetes: Systematic Review and Meta-Analysis

To our knowledge, this review provides the first comprehensive synthesis of models for risk stratification of physical frailty and cognitive frailty in older adults with diabetes. The findings indicate that existing models demonstrate satisfactory discrimination; specifically, CIs confirmed a robust average effect, while prediction intervals suggested that performance in future settings, though variable, is likely to remain acceptable. However, clinical utility is currently constrained by high risk of bias and limited external validation. Future research must prioritize rigorous, prospective, multicenter studies adhering to standard reporting guidelines (eg, TRIPOD [Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis]) to establish valid, generalizable, and clinically actionable prognostic instruments.