Frailty, Functional Status and Patient-Centered Outcomes in Older Adults With Symptomatic Peripheral Artery Disease and Aortic Aneurysmal Disease: A Scoping Review Protocol

Background Older adults with peripheral artery disease (PAD), including chronic limb-threatening ischemia (CLTI), and aortic aneurysmal disease frequently present with frailty, functional impairment, and multiple comorbidities. In this population, treatment decisions involving open surgery, endovascular interventions, or conservative management require consideration of not only anatomical and technical outcomes but also functional status, quality of life, independence, and overall prognosis. Frailty and functional status may influence treatment selection, perioperative risk, recovery, and long-term outcomes. However, the extent to which these domains are assessed and reported in the literature, and how they relate to patient-centered outcomes across different treatment strategies, requires systematic mapping. Objective To map the available evidence on the assessment of frailty and functional status, and their relationships with clinical, functional, and patient-centered outcomes, among older adults with peripheral artery disease, including chronic limb-threatening ischemia, and aortic aneurysmal disease across different management strategies. Methods This scoping review will follow the methodological framework recommended by the Joanna Briggs Institute (JBI). The review question and eligibility criteria will be structured according to the Population–Concept–Context (PCC) framework. The population will comprise older adults with peripheral artery disease, including chronic limb-threatening ischemia, or aortic aneurysmal disease. The concept will encompass frailty, functional status, their assessment using validated instruments, and their relationships with clinical and patient-centered outcomes. The context will include open surgical, endovascular, and conservative or non-operative management. Relevant evidence will be sought through systematic searches of appropriate electronic databases. Study selection and data extraction will be conducted according to the prespecified eligibility criteria. Findings will be presented descriptively and mapped to identify assessment tools, reported outcomes, evidence gaps, and opportunities for future research. Expected contribution This review aims to clarify how frailty and functional status are assessed and reported in older adults with vascular disease and to identify gaps in the evidence concerning outcomes that matter to patients, including functional independence, quality of life, recovery, and prognosis. The findings may inform more individualized, patient-centered decision-making in vascular surgery and support future research at the interface of vascular care and palliative care.