Implementation and current status of frailty assessment in Japanese hospitals: Processes, epidemiology, and future directions

Frailty has become a pressing health concern in Japan as it has entered a super-aged society. Early identification of frailty is essential to preventing disability, hospitalization, and dependency on long-term care, and yet the implementation of standardized screening across clinical settings remains inconsistent. This review synthesizes current evidence on frailty assessment practices in Japan, highlights key challenges in routine implementation, and examines the potential of emerging digital tools. The feasibility of recent digital innovations - including artificial intelligence analysis of home electricity data, wearable-based mobility monitoring, and EMR-integrated frailty indices - has been demonstrated in pilot settings, though evidence of their large-scale clinical effectiveness remains limited. International comparisons have revealed that countries and regions such as the United Kingdom, Canada, Australia, and Singapore are increasingly implementing electronic frailty indices with policy-level support, offering valuable insights for Japan. Overall, although Japan has made significant progress in recognizing the importance of frailty assessment, substantial gaps remain in standardization, system integration, and clinical implementation. Strengthening national policy frameworks, enhancing workforce training, and accelerating a digital transformation may enable the development of a more comprehensive and scalable frailty-screening system to support healthy aging.