The essence of frailty: A systematic review and qualitative synthesis on frailty concepts and definitions

Junius-Walker, Ulrike; Onder, Graziano; Soleymani, Dagmar; Wiese, Birgitt; Albaina, Olatz; Bernabei, Roberto; Marzetti, Emanuele

doi:10.1016/j.ejim.2018.04.023

Cited by 159 publications

(140 citation statements)

References 80 publications

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“…[24] Coordinated international movements towards a unifying set of frailty measures may be challenging, but will greatly aid future meta-analyses to clarify best-practice interventions. [2] Our study may be interpreted as summarising the evidence related to the physical frailty phenotype, but the results should not be extrapolated to other frailty definition approaches such as the frailty index, [59] which defines frailty according to an accumulation of deficits model which often includes more advanced disability items. Lastly, several recent publications have reported successful results of multifactorial, multidisciplinary approaches simultaneously targeting physical activity, nutrition, polypharmacy, depression, cognitive function, and other factors.…”

Section: Suggestions For Further Researchmentioning

confidence: 95%

Primary care interventions to address physical frailty among community-dwelling adults aged 60 years or older: A meta-analysis

et al. 2020

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IntroductionThe best interventions to address frailty among older adults have not yet been fully defined, and the diversity of interventions and outcome measures makes this process challenging. Consequently, there is a lack of guidance for clinicians and researchers regarding which interventions are most likely to help older persons remain robust and independent. This paper uses meta-analysis to assess effectiveness of primary care interventions for physical frailty among community-dwelling adults aged 60+ and provides an up-to-date synthesis of literature in this area. MethodsPubMed, CINAHL, Cochrane Register of Controlled Trials, and PEDro databases were searched, and RCTs, controlled pilot studies, or trials with similar study designs addressing frailty in the primary care setting among persons aged 60+ were chosen. Study data was abstracted following PRISMA guidelines, then meta-analysis was performed using the random effects model. OPEN ACCESS Citation: Macdonald SH-F, Travers J, Shé ÉN, Bailey J, Romero-Ortuno R, Keyes M, et al. (2020) Primary care interventions to address physical frailty among community-dwelling adults aged 60 years or older: A meta-analysis. PLoS ONE 15(2): e0228821. https://doi.org/10.1371/journal.

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Section: Suggestions For Further Researchmentioning

confidence: 95%

Primary care interventions to address physical frailty among community-dwelling adults aged 60 years or older: A meta-analysis

et al. 2020

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“…Pathophysiological pathways common to both HF and frailty appear to involve a multisystem cascade that includes disorders and dysregulation in neuro‐hormonal, metabolic, inflammatory, and immunologic pathways. This cascade leads to an enhanced catabolic state, energy failure, oxidative stress, and release of pro‐inflammatory signals . The up‐regulation of inflammatory biomarkers impairs hormones, such as cortisol and growth hormone, which contributes to downstream effects and leads to an enhanced catabolic state, thus favouring the occurrence of frailty.…”

Section: Frailty In Heart Failurementioning

confidence: 99%

“…This cascade leads to an enhanced catabolic state, energy failure, oxidative stress, and release of pro-inflammatory signals. [25][26][27] The up-regulation of inflammatory biomarkers impairs hormones, such as cortisol and growth hormone, which contributes to downstream effects and leads to an enhanced catabolic state, thus favouring the occurrence of frailty.…”

Section: Pathophysiologymentioning

confidence: 99%

Heart Failure Association of the European Society of Cardiology position paper on frailty in patients with heart failure

Vitale

Jankowska

Hill

et al. 2019

European J of Heart Fail

171

191

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Heart failure (HF) and frailty are two distinct yet commonly associated conditions. The interplay between the two conditions is complex, due to overlaps in underlying mechanisms, symptoms and prognosis. The assessment of frailty in patients with HF is crucial, as it is associated with both unfavourable outcomes and reduced access and tolerance to treatments. However, to date a consensus definition of frailty in patients with HF remains lacking and the need for a validated assessment score, for identifying those HF patients with frailty, is high and timely. This position paper proposes a new definition of frailty for use by healthcare professionals in the setting of HF and creates a foundation for the design of a tailored and validated score for this common condition.

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“…As numbers of older persons increase, the incidences of chronic diseases and geriatric syndromes are also likely to increase (Zaslavsky, ). One of the most important aspects of geriatric syndrome is frailty which is characterised by steady decline in physiologic reserves and functions of the older persons (Clegg, Young, Iliffe, Rikkert, & Rockwood, ; Junius‐Walker et al, ; Walston et al, ). Internationally, the prevalence of frailty among community‐ dwelling older persons has been reported to be between 4% and 59.1% and is higher in the oldest old group (Collard, Boter, Schoevers, & Oude Voshaar, ).…”

Section: Introductionmentioning

confidence: 99%

Narratives of older persons’ frailty and physical activity in relation to environmental landscapes and time

Thinuan

Siviroj

Barry

et al. 2019

Int J Older People Nursing

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Aims and objectives:The objective of this study was to explore the influence of the environmental landscape on the physical activity of older persons experiencing frailty.Background: This manuscript describes the second phase of an unpublished larger study in the northern province of Lampang, Thailand. Phase One revealed that 14% of 1,788 older persons surveyed were found to have experienced frailty according to Fried's frailty phenotypes, and low physical activity was associated with frailty. In the light of frailty, how older persons experience physical activity in their day-to-day living environments warrants in-depth exploration.Design: This was a qualitative study guided by narrative inquiry. Methods: In-depth interviews and observations were conducted with 13 older persons living with frailty. The method of analysis was thematic and performance analysis. Results: Two broad themes relating to the environmental landscapes were as follows: (a) limiting environmental landscapes and (b) engaging environmental landscapes. These landscapes, which change across time, refer to physical and social spaces, and beliefs of older persons and their family that have either positive or negative impacts on physical activity of frail older persons. Conclusion: Complex interactions between physical and social spaces and beliefs of older persons and family influence the physical activity behaviours of older persons living with frailty.

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The essence of frailty: A systematic review and qualitative synthesis on frailty concepts and definitions

Cited by 159 publications

References 80 publications

Primary care interventions to address physical frailty among community-dwelling adults aged 60 years or older: A meta-analysis

Primary care interventions to address physical frailty among community-dwelling adults aged 60 years or older: A meta-analysis

Heart Failure Association of the European Society of Cardiology position paper on frailty in patients with heart failure

Narratives of older persons’ frailty and physical activity in relation to environmental landscapes and time

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