Comparison of prestroke frailty and disability for outcome prediction in older stroke patients

Authors: Paola Forti, Marianna Ciani, Fabiola Maioli

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Journal of the Neurological Sciences.  REVIEW ARTICLE| Volume 476, 123606 September 15, 2025

DOI: https://doi.org/10.1016/j.jns.2025.123606

This article explores how different measures of a patient’s health before stroke can shape outcome prediction. Comparison of prestroke frailty and disability for outcome prediction in older stroke patients examines the role of disability, measured with the modified Rankin Scale (mRS), alongside frailty, measured with the Clinical Frailty Scale (CFS). The authors note that “prestroke disability is routinely used for clinical prognostication in acute stroke,” but their findings suggest that CFS may provide “prognostic information not provided by prestroke disability.”

In a cohort of over 4,000 older patients, CFS consistently outperformed mRS in predicting mortality, discharge outcomes, and treatment response. The study underscores the potential value of incorporating frailty assessment into routine stroke care.