Disentangling Frailty From Disability and Disease: an Empirical Analysis of Frailty Instruments
Year: 2017
Type: conference-abstract
Abstract: Frailty is conceptualized as an increased vulnerability of older adults to develop adverse health outcomes when encountering a stressor. However, operationalization has proven challenging, with numerous frailty instruments that include a wide range of age-related domains, such as physical capacity, disease, and disability. Inclusion of diseases and disability in frailty instruments obfuscates the frailty construct. Fried (2004) has argued that frailty, disability and comorbidity are interrelated but distinct entities. This distinction is critical for understanding the etiology and consequences of frailty, and for devising prevention and treatment strategies. Here we conduct a literature review to identify articles that examined: a) risk factors (such as inflammatory diseases) for frailty; and b) frailty as a risk factor for disability. We then categorize frailty instruments (n=67) used in the identified articles into 4 categories by their measures: 1) Physical Capacity plus other domains, sans disability or disease (n=26); 2) Disease plus other domains, sans disability (n=7); 3) Disability plus other domains, sans disease (n=17); and 4) Disease and Disability plus other domains (n=17). This review will provide empirical data on the use of different categories of frailty instruments in studies of upstream risk factors and of subsequent disability. Preliminary results show that 33% (10/30) of studies on risk factors for frailty used a frailty instrument containing measures of diseases and/or disability. We suggest that studies seeking to examine etiologic factors of frailty or consequences of frailty, such as disability, should not use operational definitions of frailty that include these overlapping but distinct domains.
Source: Innovation in Aging
Language: English
Topic: Frailty in Older Adults
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,977
OpenAlex ID: W2727993687