Burden of frailty in the elderly population: perspectives for a public health challenge.

[en] Frailty is a major health condition associated with ageing. Although the concept is almost universally accepted, its operational definition remains controversial. Anyway, this geriatric condition represents a huge potential public health issue at both the patient and the societal levels because of its multiple clinical, societal consequences and its dynamic nature. Here, we review existing definitions and assessment tools for frailty, we highlight consequences of this geriatric condition and we discuss the importance of its screening and prevention to limit its public health burden.

Disciplines :

General & internal medicine

Author, co-author :

Buckinx, Fanny ; Université de Liège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé

Rolland, Yves

Reginster, Jean-Yves ; Université de Liège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé

RICOUR, Céline

Petermans, Jean ; Université de Liège > Département des sciences cliniques > Gériatrie

Bruyère, Olivier ; Université de Liège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé

Language :

English

Title :

Burden of frailty in the elderly population: perspectives for a public health challenge.

Publication date :

2015

Journal title :

Archives of Public Health

ISSN :

0778-7367

eISSN :

2049-3258

Publisher :

Springer

Volume :

Issue :

Pages :

19-25

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 14 April 2015

Statistics

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87 (24 by ULiège)

Number of downloads

3 (3 by ULiège)

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Scopus citations^®

316

Scopus citations^®
without self-citations

303

OpenCitations

235

OpenAlex citations

400

Bibliography

Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet 2013, 381:752-62. 10.1016/S0140-6736(12)62167-9, 23395245.
Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: a call to action. J Am Med Dir Assoc 2013, 14:392-7. 10.1016/j.jamda.2013.03.022, 23764209.
Xue QL. The frailty syndrome: definition and natural history. Clin Geriatr Med 2011, 27:1-15. 10.1016/j.cger.2010.08.009, 21093718.
Ageing and life course. [www.who.int/ageing/age_friendly_cities/en/index.html].
Karunananthan S, Wolfson C, Bergman H, Beland F, Hogan DB. A multidisciplinary systematic literature review on frailty: overview of the methodology used by the Canadian Initiative on Frailty and Aging. BMC Med Res Methodol 2009, 9:68. 10.1186/1471-2288-9-68, 19821972.
Hogan DB, MacKnight C, Bergman H. Models, definitions, and criteria of frailty. Aging Clin Exp Res 2003, 15:1-29. 10.1007/BF03324472, 14580013.
Bergman H, Ferrucci L, Guralnik J, Hogan DB, Hummel S, Karunananthan S, et al. Frailty: an emerging research and clinical paradigm-issues and controversies. J Gerontol A Biol Sci Med Sci 2007, 62:731-7. 10.1093/gerona/62.7.731, 17634320.
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001, 56:M146-56. 10.1093/gerona/56.3.M146, 11253156.
Faber MJ, Bosscher RJ, Chin APMJ, van Wieringen PC. Effects of exercise programs on falls and mobility in frail and pre-frail older adults: A multicenter randomized controlled trial. Arch Phys Med Rehabil 2006, 87:885-96. 10.1016/j.apmr.2006.04.005, 16813773.
Peterson MJ, Sloane R, Cohen HJ, Crowley GM, Pieper CF, Morey MC. Effect of telephone exercise counseling on frailty in older veterans: project LIFE. Am J Mens Health 2007, 1:326-34. 10.1177/1557988307306153, 19482814.
Kenny AM, Boxer RS, Kleppinger A, Brindisi J, Feinn R, Burleson JA. Dehydroepiandrosterone combined with exercise improves muscle strength and physical function in frail older women. J Am Geriatr Soc 2010, 58:1707-14. 10.1111/j.1532-5415.2010.03019.x, 20863330.
Latham NK, Anderson CS, Lee A, Bennett DA, Moseley A, Cameron ID. A randomized, controlled trial of quadriceps resistance exercise and vitamin D in frail older people: the Frailty Interventions Trial in Elderly Subjects (FITNESS). J Am Geriatr Soc 2003, 51:291-9. 10.1046/j.1532-5415.2003.51101.x, 12588571.
Chin APMJ, de Jong N, Schouten EG, Hiddink GJ, Kok FJ. Physical exercise and/or enriched foods for functional improvement in frail, independently living elderly: a randomized controlled trial. Arch Phys Med Rehabil 2001, 82:811-7. 10.1053/apmr.2001.23278.
Partridge JS, Harari D, Dhesi JK. Frailty in the older surgical patient: a review. Age Ageing 2012, 41:142-7. 10.1093/ageing/afr182, 22345294.
de Vries NM, Staal JB, van Ravensberg CD, Hobbelen JS, Olde Rikkert MG, Nijhuis-van der Sanden MW. Outcome instruments to measure frailty: a systematic review. Ageing Res Rev 2011, 10:104-14. 10.1016/j.arr.2010.09.001, 20850567.
Gobbens RJ, Luijkx KG, Wijnen-Sponselee MT, Schols JM. Toward a conceptual definition of frail community dwelling older people. Nurs Outlook 2010, 58:76-86. 10.1016/j.outlook.2009.09.005, 20362776.
Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005, 173:489-95. 10.1503/cmaj.050051, 16129869.
Dartigues JF, Amieva H. Cognitive frailty: rational and definition from an (I.a.N.a./i.a.g.g.) international consensus group. J Nutr Health Aging 2014, 18:95. 10.1007/s12603-013-0437-5, 24402397.
Cesari M, Gambassi G, van Kan GA, Vellas B. The frailty phenotype and the frailty index: different instruments for different purposes. Age Ageing 2014, 43:10-2. 10.1093/ageing/aft160, 24132852.
Sternberg SA, Wershof Schwartz A, Karunananthan S, Bergman H, Mark Clarfield A. The identification of frailty: a systematic literature review. J Am Geriatr Soc 2011, 59:2129-38. 10.1111/j.1532-5415.2011.03597.x, 22091630.
Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc 2012, 60:1487-92. 10.1111/j.1532-5415.2012.04054.x, 22881367.
Bouillon K, Kivimaki M, Hamer M, Sabia S, Fransson EI, Singh-Manoux A, et al. Measures of frailty in population-based studies: an overview. BMC Geriatr 2013, 13:64. 10.1186/1471-2318-13-64, 23786540.
Rockwood K, Mitnitski A. Frailty defined by deficit accumulation and geriatric medicine defined by frailty. Clin Geriatr Med 2011, 27:17-26. 10.1016/j.cger.2010.08.008, 21093719.
Theou O, Brothers TD, Mitnitski A, Rockwood K. Operationalization of frailty using eight commonly used scales and comparison of their ability to predict all-cause mortality. J Am Geriatr Soc 2013, 61:1537-51. 10.1111/jgs.12420, 24028357.
Gill TM, Gahbauer EA, Allore HG, Han L. Transitions between frailty states among community-living older persons. Arch Intern Med 2006, 166:418-23. 10.1001/archinte.166.4.418, 16505261.
Gill TM, Baker DI, Gottschalk M, Peduzzi PN, Allore H, Byers A. A program to prevent functional decline in physically frail, elderly persons who live at home. N Engl J Med 2002, 347:1068-74. 10.1056/NEJMoa020423, 12362007.
Strawbridge WJ, Shema SJ, Balfour JL, Higby HR, Kaplan GA. Antecedents of frailty over three decades in an older cohort. J Gerontol B Psychol Sci Soc Sci 1998, 53:S9-16. 10.1093/geronb/53B.1.S9, 9469175.
Rolfson DB, Majumdar SR, Tsuyuki RT, Tahir A, Rockwood K. Validity and reliability of the Edmonton Frail Scale. Age Ageing 2006, 35:526-9. 10.1093/ageing/afl041, 16757522.
Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging 2012, 16:601-8. 10.1007/s12603-012-0084-2, 22836700.
Abellan Van Kan G, Rolland YM, Morley JE, Vellas B. Frailty: toward a clinical definition. J Am Med Dir Assoc 2008, 9:71-2. 10.1016/j.jamda.2007.11.005, 18261696.
Baitar A, Van Fraeyenhove F, Vandebroek A, De Droogh E, Galdermans D, Mebis J, et al. Evaluation of the Groningen Frailty Indicator and the G8 questionnaire as screening tools for frailty in older patients with cancer. J Geriatr Oncol 2013, 4:32-8. 10.1016/j.jgo.2012.08.001, 24071490.
Romero-Ortuno R, Walsh CD, Lawlor BA, Kenny RA. A frailty instrument for primary care: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE). BMC Geriatr 2010, 10:57. 10.1186/1471-2318-10-57, 20731877.
Gobbens RJ, van Assen MA, Luijkx KG, Wijnen-Sponselee MT, Schols JM. The Tilburg Frailty Indicator: psychometric properties. J Am Med Dir Assoc 2010, 11:344-55. 10.1016/j.jamda.2009.11.003, 20511102.
Searle SD, Mitnitski A, Gahbauer EA, Gill TM, Rockwood K. A standard procedure for creating a frailty index. BMC Geriatr 2008, 8:24. 10.1186/1471-2318-8-24, 18826625.
Vellas B, Balardy L, Gillette-Guyonnet S, Abellan Van Kan G, Ghisolfi-Marque A, Subra J, et al. Looking for frailty in community-dwelling older persons: the Gerontopole Frailty Screening Tool (GFST). J Nutr Health Aging 2013, 17:629-31. 10.1007/s12603-013-0363-6, 23933875.
Chen CY, Wu SC, Chen LJ, Lue BH. The prevalence of subjective frailty and factors associated with frailty in Taiwan. Arch Gerontol Geriatr 2010, 50(Suppl 1):S43-7. 10.1016/S0167-4943(10)70012-1, 20171456.
Santos-Eggimann B, Cuenoud P, Spagnoli J, Junod J. Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries. J Gerontol A Biol Sci Med Sci 2009, 64:675-81. 10.1093/gerona/glp012, 19276189.
Syddall H, Roberts HC, Evandrou M, Cooper C, Bergman H, Aihie Sayer A. Prevalence and correlates of frailty among community-dwelling older men and women: findings from the Hertfordshire Cohort Study. Age Ageing 2010, 39:197-203. 10.1093/ageing/afp204, 20007127.
Matusik P, Tomaszewski K, Chmielowska K, Nowak J, Nowak W, Parnicka A, et al. Severe frailty and cognitive impairment are related to higher mortality in 12-month follow-up of nursing home residents. Arch Gerontol Geriatr 2012, 55:22-4. 10.1016/j.archger.2011.06.034, 21764151.
Freiheit EA, Hogan DB, Strain LA, Schmaltz HN, Patten SB, Eliasziw M, et al. Operationalizing frailty among older residents of assisted living facilities. BMC Geriatr 2011, 11:23. 10.1186/1471-2318-11-23, 21569509.
Gonzalez-Vaca J, de la Rica-Escuin M, Silva-Iglesias M, Arjonilla-Garcia MD, Varela-Perez R, Oliver-Carbonell JL, et al. Frailty in INstitutionalized older adults from ALbacete. The FINAL Study: rationale, design, methodology, prevalence and attributes. Maturitas 2014, 77:78-84. 10.1016/j.maturitas.2013.10.005, 24189222.
Rockwood K, Abeysundera MJ, Mitnitski A. How should we grade frailty in nursing home patients?. J Am Med Dir Assoc 2007, 8:595-603. 10.1016/j.jamda.2007.07.012, 17998116.
Jurschik P, Nunin C, Botigue T, Escobar MA, Lavedan A, Viladrosa M. Prevalence of frailty and factors associated with frailty in the elderly population of Lleida, Spain: the FRALLE survey. Arch Gerontol Geriatr 2012, 55:625-31. 10.1016/j.archger.2012.07.002, 22857807.
Avila-Funes JA, Amieva H, Barberger-Gateau P, Le Goff M, Raoux N, Ritchie K, et al. Cognitive impairment improves the predictive validity of the phenotype of frailty for adverse health outcomes: the three-city study. J Am Geriatr Soc 2009, 57:453-61. 10.1111/j.1532-5415.2008.02136.x, 19245415.
Moreira VG, Lourenco RA. Prevalence and factors associated with frailty in an older population from the city of Rio de Janeiro, Brazil: the FIBRA-RJ Study. Clinics (Sao Paulo) 2013, 68:979-85. 10.6061/clinics/2013(07)15.
Hamerman D. Toward an understanding of frailty. Ann Intern Med 1999, 130:945-50. 10.7326/0003-4819-130-11-199906010-00022, 10375351.
Castell MV, Sanchez M, Julian R, Queipo R, Martin S, Otero A. Frailty prevalence and slow walking speed in persons age 65 and older: implications for primary care. BMC Fam Pract 2013, 14:86. 10.1186/1471-2296-14-86, 23782891.
Haute Autorité de Santé. Santé HAd: Comment repérer la fragilité en soins ambulatoires, 2013: 1-7..
Stratégie Nationale de Santé: Santé ARd: Projet Paerpa. 2013: 1-26..
Ogawa K, Fujiwara Y, Yoshida H, Nishi M, Fukaya T, Kim M, et al. The validity of the " Kihon Check-list" as an index of frailty and its biomarkers and inflammatory markers in elderly people. Nihon Ronen Igakkai Zasshi 2011, 48:545-52. 10.3143/geriatrics.48.545, 22323034.
Ricour C, de Saint-Hubert M, Allepaerts S, Petermans J. Screening for frailty: a benefit for both patients and physicians. Rev Med Liege 2014, 69:239-43. 25065226.
Morley JE. Frailty: diagnosis and management. J Nutr Health Aging 2011, 15:667-70. 10.1007/s12603-011-0338-4, 21968862.
Rockwood K, Howlett SE, MacKnight C, Beattie BL, Bergman H, Hebert R, et al. Prevalence, attributes, and outcomes of fitness and frailty in community-dwelling older adults: report from the Canadian study of health and aging. J Gerontol A Biol Sci Med Sci 2004, 59:1310-7. 10.1093/gerona/59.12.1310, 15699531.
Bandeen-Roche K, Xue QL, Ferrucci L, Walston J, Guralnik JM, Chaves P, et al. Phenotype of frailty: characterization in the women's health and aging studies. J Gerontol A Biol Sci Med Sci 2006, 61:262-6. 10.1093/gerona/61.3.262, 16567375.
Ensrud KE, Ewing SK, Taylor BC, Fink HA, Cawthon PM, Stone KL, et al. Comparison of 2 frailty indexes for prediction of falls, disability, fractures, and death in older women. Arch Intern Med 2008, 168:382-9. 10.1001/archinternmed.2007.113, 18299493.
Lafont C, Gerard S, Voisin T, Pahor M, Vellas B. Reducing " iatrogenic disability" in the hospitalized frail elderly. J Nutr Health Aging 2011, 15:645-60. 10.1007/s12603-011-0335-7, 21968859.
Fairhall N, Aggar C, Kurrle SE, Sherrington C, Lord S, Lockwood K, et al. Frailty Intervention Trial (FIT). BMC Geriatr 2008, 8:27. 10.1186/1471-2318-8-27, 18851754.
de Vries NM, van Ravensberg CD, Hobbelen JS, Olde Rikkert MG, Staal JB, Nijhuis-van der Sanden MW. Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-dwelling older adults with impaired mobility, physical disability and/or multi-morbidity: a meta-analysis. Ageing Res Rev 2012, 11:136-49. 10.1016/j.arr.2011.11.002, 22101330.
Theou O, Stathokostas L, Roland KP, Jakobi JM, Patterson C, Vandervoort AA, et al. The effectiveness of exercise interventions for the management of frailty: a systematic review. J Aging Res 2011, 2011:569194. 10.4061/2011/569194, 21584244.
Morley JE. Do frail older persons need more protein?. J Am Med Dir Assoc 2012, 13:667-8. 10.1016/j.jamda.2012.07.014, 22951026.
Tieland M, van de Rest O, Dirks ML, van der Zwaluw N, Mensink M, van Loon LJ, et al. Protein supplementation improves physical performance in frail elderly people: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc 2012, 13:720-6. 10.1016/j.jamda.2012.07.005, 22889730.
Cawood AL, Elia M, Stratton RJ. Systematic review and meta-analysis of the effects of high protein oral nutritional supplements. Ageing Res Rev 2012, 11:278-96. 10.1016/j.arr.2011.12.008, 22212388.
Murad MH, Elamin KB, Abu Elnour NO, Elamin MB, Alkatib AA, Fatourechi MM, et al. Clinical review: the effect of vitamin D on falls: a systematic review and meta-analysis. J Clin Endocrinol Metab 2011, 96:2997-3006. 10.1210/jc.2011-1193, 21795448.
Rejnmark L, Avenell A, Masud T, Anderson F, Meyer HE, Sanders KM, et al. Vitamin D with calcium reduces mortality: patient level pooled analysis of 70,528 patients from eight major vitamin D trials. J Clin Endocrinol Metab 2012, 97:2670-81. 10.1210/jc.2011-3328, 22605432.
Kojima G, Bell C, Tamura B, Inaba M, Lubimir K, Blanchette PL, et al. Reducing cost by reducing polypharmacy: the polypharmacy outcomes project. J Am Med Dir Assoc 2012, 13:818.e811-815. 10.1016/j.jamda.2012.07.019.
Cameron ID, Fairhall N, Langron C, Lockwood K, Monaghan N, Aggar C, et al. A multifactorial interdisciplinary intervention reduces frailty in older people: randomized trial. BMC Med 2013, 11:65. 10.1186/1741-7015-11-65, 23497404.
van de Rest O, van der Zwaluw NL, Tieland M, Adam JJ, Hiddink GJ, van Loon LJ, et al. Effect of resistance-type exercise training with or without protein supplementation on cognitive functioning in frail and pre-frail elderly: secondary analysis of a randomized, double-blind, placebo-controlled trial. Mech Ageing Dev 2014, 136-137:85-93. 10.1016/j.mad.2013.12.005, 24374288.
Nazir A, Unroe K, Tegeler M, Khan B, Azar J, Boustani M. Systematic review of interdisciplinary interventions in nursing homes. J Am Med Dir Assoc 2013, 14:471-8. 10.1016/j.jamda.2013.02.005, 23566932.
Fairhall N, Sherrington C, Kurrle SE, Lord SR, Lockwood K, Howard K, et al. Economic evaluation of a multifactorial, interdisciplinary intervention versus usual care to reduce frailty in frail older people. J Am Med Dir Assoc 2015, 16(1):41-8. 10.1016/j.jamda.2014.07.006, 25239014.