Literature review on the concepts and definitions of frailty in elderly

Abstract

Objective: To present the most prevalent definitions of frailty in elderly, in scientific review articles addressing that subject. Methods: A systematic literature review was conducted using the following inclusion criteria: (1) review articles about concepts and definitions of frailty in elderly, focusing on the lack of consensus over the term “frailty”; (2) publication ranging from January, 1980 to December, 2007; (3) written in English, French, Spanish or Portuguese. The review was carried out by searching into 5 data-basis: Ageline, LILACS, Medline, PsycINFO, and Scielo, using the following keywords: frailty OR frail elderly, definition OR concept, definitions OR concepts. The search through Scielo was performed using the terms: fragilidade OR idoso frágil, definição OR conceito, definições OR conceitos. Results: Eight review articles met the inclusion criteria. Two of them were systematic review studies, and six were non-systematic reviews. The physical performance domain was prevalent among the definitions. Dependence in activities of daily living (ADLs) was the main component of frailty. Despite variability among definitions, most of them are framed in terms of dependence in ADL/disability, age, disease, and homeostatic disturbances. Conclusion: The multiplicity of both concepts and definitions of frailty in the field of gerontology and geriatrics indicates the difficulty to reach a consensual definition of frailty in elderly people.