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Searching for an Operational Definition of Frailty: A Delphi Method Based Consensus Statement. The Frailty Operative Definition-Consensus Conference Project

TLDR
There is agreement on the usefulness of defining frailty in clinical settings as well as on its main dimensions, however, additional research is needed before an operative definition of frailty can be established.
Abstract
BACKGROUND: There is no consensus regarding the definition of frailty for clinical uses. METHODS: A modified Delphi process was used to attempt to achieve consensus definition. Experts were selected from different fields and organized into five Focus Groups. A questionnaire was developed and sent to experts in the area of frailty. Responses and comments were analyzed using a pre-established strategy. Statements with an agreement more than or equal to 80% were accepted. RESULTS: Overall, 44% of the statements regarding the concept of frailty and 18% of the statements regarding diagnostic criteria were accepted. There was consensus on the value of screening for frailty and about the identification of six domains of frailty for inclusion in a clinical definition, but no agreement was reached concerning a specific set of clinical/laboratory biomarkers useful for diagnosis. CONCLUSIONS: There is agreement on the usefulness of defining frailty in clinical settings as well as on its main dimensions. However, additional research is needed before an operative definition of frailty can be established.

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Citations
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Journal ArticleDOI

Frailty measurement in research and clinical practice: A review

TL;DR: How well these measurements operationalise frailty according to Clegg's guidelines for frailty classification is examined - that is: their accuracy in identifying frailty; their basis on biological causative theory; and their ability to reliably predict patient outcomes and response to potential therapies.
Journal ArticleDOI

Effects of different exercise interventions on risk of falls, gait ability and balance in physically frail older adults. A systematic review

TL;DR: The multi-component exercise intervention composed by strength, endurance and balance training seems to be the best strategy to improve rate of falls, gait ability, balance, and strength performance in physically frail older adults.
References
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Journal ArticleDOI

Outcome instruments to measure frailty: A systematic review

TL;DR: A systematic review on evaluative measures of frailty was performed in the databases PubMed, EMBASE, Cinahl and Cochrane to give a clear overview of the content and clinimetric properties of several frailty instruments.
Journal ArticleDOI

The Delphi method: Substance, context, a critique and an annotated bibliography

TL;DR: The methodology and its historical development are described, it is placed in context vis-a-vis other methods of subjective scaling, and a critique is provided.
Journal ArticleDOI

Redefining geriatric preoperative assessment using frailty, disability and co-morbidity.

TL;DR: Geriatric assessment markers for frailty, disability and comorbidity predict 6-month postoperative mortality and postdischarge institutionalization and preoperative assessment using geriatric-specific markers is a substantial paradigm shift from the traditional preoperative evaluation of older adults.
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