There are many different conceptual definitions of frailty in circulation. Most of these definitions focus mainly on physical problems affecting older people. Only a few also draw attention to other domains of human functioning such as the psychological domain. The authors of this article fear that this could lead to fragmentation of care for frail older people. The aim is to develop an integral conceptual definition of frailty that starts from the premise of a holistic view of the person.
To achieve this, a literature search was carried out. Thereafter a group of experts (N=20) were consulted, both verbally during 2 expert meetings and via a written questionnaire. These experts were asked which existing conceptual definition of frailty places most stress on the integral functioning of older people.
The experts expressed a clear preference for one of the conceptual definitions. The result of the literature search and the consultation with the experts led to a new integral conceptual definition of frailty.
The conceptual definition is intended to offer a framework for an operational definition of frailty for identifying frail older people.
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- [Frail elderly. Identification of a population at risk.].Tijdschr Gerontol Geriatr. 2007; 38: 65-76
- Editorial: Something about frailty.J Gerontol A Biol Sci Med Sci. 2002; 57: M698-M704
- A program to prevent functional decline in physically frail, elderly persons who live at home.N Engl J Med. 2002; 347: 1068-1074
- Old or frail: What tells us more?.J Gerontol A Biol Sci Med Sci. 2004; 59: M962-M965
- The mortality rate as a function of accumulated deficits in a frailty index.Mech Ageing Dev. 2002; 123: 1457-1460
- Defining the concept of frailty: A survey of multi-disciplinary health professionals. Geriatrics Today.J Can Geriatr Soc. 2003; 6: 26-31
- Frailty in older adults: Evidence for a phenotype.J Gerontol A Biol Sci Med Sci. 2001; 56: M146-M156
- Report of the Council on Scientific Affairs.Arch Intern Med. 1990; 150: 2459-2472
- Conceptualizations of frailty in relation to older adults.J Adv Nurs. 2003; 44: 58-68
- Models, definitions, and criteria of frailty.Aging Clin Exp Res. 2003; 15: 1-29
- Targeting frail older adults for outpatient comprehensive geriatric assessment and management services: An overview of concepts and criteria.Rev Clin Gerontol. 2002; 12: 82-92
- Factors contributing to frailty: Literature review.J Adv Nurs. 2006; 56: 282-291
- Preventing frail health.Clin Geriatr Med. 1992; 8: 1-17
- Toward an understanding of frailty.Ann Intern Med. 1999; 130: 945-950
- Conceptualisation and measurement of frailty in elderly people.Drugs Aging. 2000; 17: 295-302
- The global challenge of understanding and meeting the needs of the frail older population.Aging Clin Exp Res. 2002; 14: 223-225
- What would make a definition of frailty successful?.Age Ageing. 2005; 34: 432-434
- Antecedents of frailty over three decades in an older cohort.J Gerontol B Psychol Sci Soc Sci. 1998; 53: S9-16
- A brief clinical instrument to classify frailty in elderly people.Lancet. 1999; 353: 205-206
- Sex differences in the risk of frailty for mortality independent of disability and chronic diseases.J Am Geriatr Soc. 2005; 53: 40-47
- Instrumental activities of daily living as a potential marker of frailty: A study of 7364 community-dwelling elderly women (the EPIDOS study).J Gerontol A Biol Sci Med Sci. 2001; 56: M448-M453
- The oldest old: autonomy in the face of frailty.J Aging Stud. 1994; 8: 59-76
- The social construction of frailty: An anthropological perspective.J Aging Stud. 1994; 8: 45-58
- Frailty: A public health perspective.Can J Public Health. 1995; 86: 224-227
- The physics of frailty.J Am Geriatr Soc. 1993; 41: 1004-1008
- Static and dynamic measures of frailty predicted decline in performance-based and self-reported physical functioning.J Clin Epidemiol. 2005; 58: 1188-1198
- [The importance of the ‘frailty-concept’ in geriatric assessment.].Tijdschr Gerontol Geriatr. 1998; 29: 276-278
- Reducing disability in older age.JAMA. 2002; 288: 3164-3166
- Unstable disability and the fluctuations of frailty.Age Ageing. 1997; 26: 315-318
- Frailty in elderly people: An evolving concept.CMAJ. 1994; 150: 489-495
- Frailty: Constructing a common meaning, definition, and conceptual framework.Int J Rehabil Res. 1995; 18: 93-102
- Targeting the hospitalized elderly for geriatric consultation.J Am Geriatr Soc. 1988; 36: 1113-1119
- Untangling the concepts of disability, frailty, and comorbidity: Implications for improved targeting and care.J Gerontol A Biol Sci Med Sci. 2004; 59: 255-263
- The disablement process.Soc Sci Med. 1994; 38: 1-14
- Flies without wings.in: Carey R. Robine J.-M. Michael J.-P. Christen Y. Longevity and Frailty. Springer-Verlag, Heidelberg2005: 67-81
- Frailty.Med Clin North Am. 2006; 90: 837-847
- Frailty: An emerging research and clinical paradigm—issues and controversies.J Gerontol A Biol Sci Med Sci. 2007; 62: 731-737
- Clinical Global Impression of Change in Physical Frailty: Development of a measure based on clinical judgment.J Am Geriatr Soc. 2004; 52: 1560-1566
- The I.A.N.A Task Force on frailty assessment of older people in clinical practice.J Nutr Health Aging. 2008; 12: 29-37
- Frailty: Toward a clinical definition.J Am Med Dir Assoc. 2008; 9: 71-72
Published online: March 25, 2010
The authors have no conflicts of interest and no financial support regarding this article.
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