Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

ACC 2024 Congress

Catch up on all the top stories and latest evidence in cardiology research with our ACC 2024 Congress hub page.
ADVANCED SEARCH
Log in
Top
Archives of Public Health
Published in: Archives of Public Health 1/2015

Open Access 01-12-2015 | Commentary

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

Authors: Fanny Buckinx, Yves Rolland, Jean-Yves Reginster, Céline Ricour, Jean Petermans, Olivier Bruyère

Published in: Archives of Public Health | Issue 1/2015

Login to get access

Abstract

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.
Literature
1.
Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381:752–62.CrossRefPubMed
2.
3.
4.
5.
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.CrossRefPubMedPubMedCentral
6.
Hogan DB, MacKnight C, Bergman H. Models, definitions, and criteria of frailty. Aging Clin Exp Res. 2003;15:1–29.CrossRefPubMed
7.
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.CrossRefPubMedPubMedCentral
8.
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.CrossRefPubMed
9.
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.CrossRefPubMed
10.
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.CrossRefPubMed
11.
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.CrossRefPubMed
12.
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.CrossRefPubMed
13.
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.CrossRef
14.
Partridge JS, Harari D, Dhesi JK. Frailty in the older surgical patient: a review. Age Ageing. 2012;41:142–7.CrossRefPubMed
15.
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.CrossRefPubMed
16.
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.CrossRefPubMed
17.
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.CrossRefPubMedPubMedCentral
18.
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.CrossRefPubMed
19.
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.CrossRefPubMed
20.
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.CrossRefPubMed
21.
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.CrossRefPubMed
22.
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.CrossRefPubMedPubMedCentral
23.
Rockwood K, Mitnitski A. Frailty defined by deficit accumulation and geriatric medicine defined by frailty. Clin Geriatr Med. 2011;27:17–26.CrossRefPubMed
24.
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.CrossRefPubMed
25.
Gill TM, Gahbauer EA, Allore HG, Han L. Transitions between frailty states among community-living older persons. Arch Intern Med. 2006;166:418–23.CrossRefPubMed
26.
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.CrossRefPubMed
27.
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.CrossRefPubMed
28.
Rolfson DB, Majumdar SR, Tsuyuki RT, Tahir A, Rockwood K. Validity and reliability of the Edmonton Frail Scale. Age Ageing. 2006;35:526–9.CrossRefPubMed
29.
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.CrossRefPubMedPubMedCentral
30.
Abellan van Kan G, Rolland YM, Morley JE, Vellas B. Frailty: toward a clinical definition. J Am Med Dir Assoc. 2008;9:71–2.CrossRefPubMed
31.
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.CrossRefPubMed
32.
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.CrossRefPubMedPubMedCentral
33.
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.CrossRefPubMed
34.
35.
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.CrossRefPubMed
36.
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.CrossRefPubMed
37.
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.CrossRefPubMed
38.
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.CrossRefPubMed
39.
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.CrossRefPubMed
40.
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.CrossRefPubMedPubMedCentral
41.
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.CrossRefPubMed
42.
Rockwood K, Abeysundera MJ, Mitnitski A. How should we grade frailty in nursing home patients? J Am Med Dir Assoc. 2007;8:595–603.CrossRefPubMed
43.
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.CrossRefPubMed
44.
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.CrossRefPubMed
45.
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.CrossRef
46.
47.
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.CrossRefPubMedPubMedCentral
48.
Haute Autorité de Santé. Santé HAd: Comment repérer la fragilité en soins ambulatoires, 2013: 1-7.
49.
Stratégie Nationale de Santé: Santé ARd: Projet Paerpa. 2013: 1-26.
50.
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.CrossRefPubMed
51.
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.PubMed
52.
53.
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.CrossRefPubMed
54.
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.CrossRefPubMed
55.
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.CrossRefPubMed
56.
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.CrossRefPubMed
57.
58.
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.CrossRefPubMed
59.
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.CrossRefPubMedPubMedCentral
60.
61.
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.CrossRefPubMed
62.
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.CrossRefPubMed
63.
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.CrossRefPubMed
64.
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.CrossRefPubMedPubMedCentral
65.
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.CrossRef
66.
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.CrossRefPubMedPubMedCentral
67.
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.CrossRefPubMed
68.
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.CrossRefPubMed
69.
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.CrossRefPubMed
Metadata
Title
Burden of frailty in the elderly population: perspectives for a public health challenge
Authors
Fanny Buckinx
Yves Rolland
Jean-Yves Reginster
Céline Ricour
Jean Petermans
Olivier Bruyère
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Archives of Public Health / Issue 1/2015
Electronic ISSN: 2049-3258
DOI
https://doi.org/10.1186/s13690-015-0068-x

Other articles of this Issue 1/2015

Archives of Public Health 1/2015 Go to the issue

Research

Wealth status and sex differential of household head: implication for source of drinking water in Nigeria

Research

Educational inequalities in young-adult mortality between the 1990s and the 2000s: regional differences in Belgium

Research

Health insurance and maternal, newborn services utilisation and under-five mortality

Research

Reported incidence of fever for under-5 children in Zambia: a longitudinal study

Research

The nutrition transition in Colombia over a decade: a novel household classification system of anthropometric measures

Research

Legionnaires’ disease: overview of the situation concerning notification in Wallonia (Belgium) in 2012, a retrospective descriptive study based on a capture-recapture method