A Review of Frailty Syndrome and Its Physical, Cognitive and Emotional Domains in the Elderly

Abstract

Abstract:Background: Frailty, a very important complication of increasing age, is a well-recognised concept although it has not been accurately measured in the clinical setting. The aim of this literature review is to summarise commonly used frailty screening tools, and to describe how new measurement methods have been developed recently. Methods: Several frailty measurement tools including the most cited and newly developed scales have been described in this review. We searched the MEDLINE using the search terms; "frailty score, scale, tool, instrument, index, phenotype" and then summarised selected tools for physical, cognitive, emotional and co-morbidity domains. Results: The most cited frailty measurement methods developed from 1999 to 2005 are primarily criteria for physical frailty (e.g., frailty phenotype). More recently developed tools (e.g., triad of impairment and multidimensional frailty score) consider cognitive and emotional domains in addition to physical deficit in measuring frailty. Co-morbidity has also been considered as a domain of frailty in several measurement tools. Conclusion: Although frailty tools have traditionally assessed physical capability, cognitive and emotional impairment often co-exist in older adults and may have shared origins. Therefore, newer tools which provide a composite measure of frailty may be more relevant for future use.

Current Understanding of the Role of Frailty in Cardiovascular Disease

“…Social changes include an increasing prevalence of nuclear families, along with a greater number of the elderly living alone, whereas cognitive elements may be age-related dementia or illness. 4 We need to address not only physical frailty but also social and cognitive frailty; therefore, this review extensively discusses frailty. In Japan, the number of CVD cases has recently increased because of the aging population and the diffusion of the Western diet, and CVD is now the secondhighest cause of death.…”

Multidimensional Approach to Frailty

“…In the literature, there are one-dimensional tools for assessing FS most often intended to screen for physical frailty, but multidimensional tools are becoming popular in clinical practice. The most frequently cited assessment of FS includes Frailty Phenotype, Frailty Index, and Clinical Frailty Scale (Khezrian et al, 2017). Multidimensional measures of FS can provide clinicians with more data on patients' needs, their initial vulnerability, and also enable individualized therapeutic management.…”

Wearable Sensors and the Assessment of Frailty among Vulnerable Older Adults: An Observational Cohort Study

“…The Fried frailty phenotype has several diagnostic limitations. The Fried approach has been described as impractical in a busy clinic settings [ 15 ], not designed for inpatient or bed-bound older patients [ 16 ], not sensitive to subtle physiological changes [ 17 ], and as failing to account for the important domain of cognition function [ 18 ]. Additionally, the approach’s reliance on questionnaires to identify weight loss, exhaustion, and energy expenditure suffers from participant bias [ 19 , 20 , 21 , 22 ].…”