Frailty Theory

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Introduction Frailty is a term which is synonymous with the geriatric population and while the biology of frailty is generally understood, there exists major divergence of opinion in its conceptual definition, technicalities and operationalization.1 Its multidimensional nature impacts on the interconnected variables of health and quality of life (QOL) which has necessitated the development of multiple clinically applicable tools for the detection and quantification of frailty. Multidisciplinary approaches have been developed to manage its wide spectrum of effects. These approaches are complimentary to preventative strategies which seek to pre-empt patient deterioration from a prefrail or robust state. Frailty is a ubiquitous element of…show more content…
Only recently was a consensus definition of frailty agreed among field experts as “a multidimensional syndrome characterized by decreased reserve and diminished resistance to stressors” before which conceptual definitions varied extensively between literature.2 The same experts, however, could not reach agreement on a unanimous operational definition, this being indicative of the numerous screening tools available for the identification of frailty. The operationalization of frailty relates directly to the determinants used, determinant in this case referring to a characteristic whose presence in a patient may precipitate a diagnosis of frailty. It is important to note that determinants of frailty vary between screening tools thus allowing clinicians or researchers select tools that best suit their unique needs.3 This highlights a reason for the difficulty in reaching a standard operationalization but also shows a benefit via the wide variety of tools available to academics of different…show more content…
Both of these pathways precipitate entry into the hypothesised frailty cycle which specifically underlies the FP.13 Increased age and presence of comorbid diseases are not prerequisites of frailty but do increase its risk in a correlative manner. It is most important however that disability is delineated from and clearly defined in terms of frailty. It is now generally accepted that disability occurs as a result of frailty rather than comprising it, with experts recently recognising the two concepts as distinct entities.2, 14 One can become disabled as a result of frailty but usually one does not become frail because of a disability. Furthermore, the clear definition of disability as “difficulty or dependency in carrying out activities essential to independent living, including essential roles, tasks needed for self-care and living independently in a home, and desired activities important to one’s quality of life” in combination with the agreement of the frailty/disability relationship allows for quantitative analysis of the impact of frailty on health and QOL.15 QOL is a highly subjective multi-dimensional concept. Its definition and quantitative measure
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