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Article History

Received: 9 July 2025

Accepted: 18 September 2025

First Online: 14 October 2025

Declarations

:

: PMS, LLL and JCMC declare that they have no conflicts of interest to disclose. MKA reports research grants from Sanofi, GSK, Pfizer and Merck, unrelated to the present study. Olga Theou, with Kenneth Rockwood, have asserted copyright of the Pictorial Fit–Frail Scale, which is made freely available for education, research and not-for-profit healthcare. Licenses for commercial use are facilitated through the Dalhousie Office of Commercialization and Industry Engagement. This frailty tool was not used in the present study.

: No sponsors participated in the design, methods, data analysis, or preparation of this manuscript.

: This study was approved by the Santiago-Lugo Research Ethics Committee and the Spanish Drug Agency (AEMPS) (protocol LAO-PAR-2018-01). All procedures were conducted in accordance with the ethical standards of the Declaration of Helsinki and the principles outlined in the Belmont Report, including respect for persons, beneficence, and justice. Written informed consent was obtained from all participants prior to inclusion. Participants were informed of the study’s objectives, the voluntary nature of their participation, and the anonymization of their data. No personal identifiers were retained in the final dataset.

: All participants provided written informed consent to participate in the study and for publication of anonymized data.

: The datasets generated and analyzed during the present study are available from the corresponding author upon reasonable request.

: No custom code was generated or used for this study. Statistical analyses were conducted using IBM ® SPSS ® Statistics, version 28.0.1.1.

: All authors have reviewed and approved the final version of this manuscript. PMS led the data collection efforts. The study concept and design were developed collaboratively by PMS, LLL, JMC, MKA and OT. PMS, OT and MKA were responsible for the development of the frailty index and the statistical analysis. PMS drafted the manuscript, with all authors contributing to critical revisions and enhancing the intellectual content of the paper.