The Identification of Frailty: A Systematic Literature Review
Abstract
An operational definition of frailty is important for clinical care, research, and policy planning. The literature on the clinical definitions, screening tools, and severity measures of frailty were systematically reviewed as part of the Canadian Initiative on Frailty and Aging. Searches of MEDLINE from 1997 to 2009 were conducted, and reference lists of retrieved articles were pearled, to identify articles published in English and French on the identification of frailty in community‐dwelling people aged 65 and older. Two independent reviewers extracted descriptive information on study populations, frailty criteria, and outcomes from the selected papers, and quality rankings were assigned. Of 4,334 articles retrieved from the searches and 70 articles retrieved from the pearling, 22 met study inclusion criteria. In the 22 articles, physical function, gait speed, and cognition were the most commonly used identifying components of frailty, and death, disability, and institutionalization were common outcomes. The prevalence of frailty ranged from 5% to 58%. Despite significant work over the past decade, a clear consensus definition of frailty does not emerge from the literature. The definition and outcomes that best suit the unique needs of the researchers, clinicians, or policy‐makers conducting the screening determine the choice of a screening tool for frailty. Important areas for further research include whether disability should be considered a component or an outcome of frailty. In addition, the role of cognitive and mood elements in the frailty construct requires further clarification.
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The Frail Elderly Functional Questionnaire (19 items) was identified as a potential outcome measure for frailty intervention studies because it is suitable for telephone or proxy use, valid and reliable, and sensitive to change.
“The Frail Elderly Functional Questionnaire (19 items) was identified as a potential outcome measure for frailty intervention studies as it is suitable for use by telephone or proxy, valid and reliable (100), and is sensitive to change (101).”
From Frailty in elderly people (2013) · cites this paper as [100]
Cites
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“Whether exploring the etiologies and predictors of frailty, or interventions to prevent and treat frailty, researchers need a clear definition to define their study populations and measure their results.(8,9,16) Similarly, policy decisions regarding the distribution of scarce resources to help frail older adults and p…”
BackgroundOperationalizing a frailty index from a standardized comprehensive geriatric assessment
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“When disability is left out of the measure of frailty, a tool emerges that aims to identify risk in a population that is functionally independent.(6) Designing interventions to delay the onset of frailty in this population would be analogous to primary prevention (Figure 4).”
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The Role of Sirtuins in Sarcopenia and Frailty
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- Authors
- Sternberg, S. A., Schwartz, A. W., Karunananthan, S., Bergman, H., & Mark Clarfield, A.
- Affiliations
- Maccabi Healthcare Services (IL)
- Icahn School of Medicine at Mount Sinai (US)
- McGill University (CA)
- Jewish General Hospital (CA)
- Division of Geriatric Medicine McGill University Sir Mortimer B. Davis—Jewish General Hospital Montreal Canada
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2011-09-21
- Volume
- 59
- Issue
- 11
- Pages
- 2129-2138
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- OpenAlex
- W2030265211
- Cited by
- 703
- References
- 7
- Citations by year
- 2026: 15 · 2025: 36 · 2024: 48 · 2023: 41 · 2022: 39 · 2021: 49 · 2020: 43 · 2019: 71 · 2018: 53 · 2017: 54 · 2016: 50 · 2015: 61 · 2014: 57 · 2013: 59 · 2012: 26
- FWCI
- 3.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Max Bell Foundation
- Réseau québécois de recherche sur le vieillissement
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- frailty, frailty identification, frailty screening tools, frailty definition, community-dwelling older adults, physical function, walking speed, cognition, disability, institutionalization, mortality, frailty prevalence
- MeSH terms
- Aged, 80 and over, Aging, Humans, Geriatric Assessment, Frail Elderly, Consensus
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