TY - JOUR
T1 - Early identification of frailty
T2 - Developing an international delphi consensus on pre-frailty
AU - Sezgin, Duygu
AU - O'Donovan, Mark
AU - Woo, Jean
AU - Bandeen-Roche, Karen
AU - Liotta, Giuseppe
AU - Fairhall, Nicola
AU - Rodríguez-Laso, Angel
AU - Apóstolo, João
AU - Clarnette, Roger
AU - Holland, Carol
AU - Roller-Wirnsberger, Regina
AU - Illario, Maddalena
AU - Mañas, Leocadio Rodríguez
AU - Vollenbroek-Hutten, Miriam
AU - Doğu, Burcu Balam
AU - Balci, Cafer
AU - Pernas, Francisco Orfila
AU - Paul, Constança
AU - Ahern, Emer
AU - Romero-Ortuno, Roman
AU - Molloy, William
AU - Cooney, Maria Therese
AU - O'Shea, Diarmuid
AU - Cooke, John
AU - Lang, Deirdre
AU - Hendry, Anne
AU - Kennelly, Siobhán
AU - Rockwood, Kenneth
AU - Clegg, Andrew
AU - Liew, Aaron
AU - O'Caoimh, Rónán
N1 - Funding Information:
Dr Rónán O'Caoimh, Dr Aaron Liew, Dr Duygu Sezgin and Mr Mark O'Donovan received funding through the ‘ADVANTAGE’ Joint Action on Frailty Prevention, financed under the European Union's Health Programme (2014–2020) , grant number 724099 .
Publisher Copyright:
© 2021
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Background:: Frailty is associated with a prodromal stage called pre-frailty, a potentially reversible and highly prevalent intermediate state before frailty becomes established. Despite being widely-used in the literature and increasingly in clinical practice, it is poorly understood. Objective:: To establish consensus on the construct and approaches to diagnose and manage pre-frailty. Methods:: We conducted a modified (electronic, two-round) Delphi consensus study. The questionnaire included statements concerning the concept, aspects and causes, types, mechanism, assessment, consequences, prevention and management of pre-frailty. Qualitative and quantitative analysis methods were employed. An agreement level of 70% was applied. Results:: Twenty-three experts with different backgrounds from 12 countries participated. In total, 70 statements were circulated in Round 1. Of these, 52.8% were accepted. Following comments, 51 statements were re-circulated in Round 2 and 92.1% were accepted. It was agreed that physical and non-physical factors including psychological and social capacity are involved in the development of pre-frailty, potentially adversely affecting health and health-related quality of life. Experts considered pre-frailty to be an age-associated multi-factorial, multi-dimensional, and non-linear process that does not inevitably lead to frailty. It can be reversed or attenuated by targeted interventions. Brief, feasible, and validated tools and multidimensional assessment are recommended to identify pre-frailty. Conclusions:: Consensus suggests that pre-frailty lies along the frailty continuum. It is a multidimensional risk-state associated with one or more of physical impairment, cognitive decline, nutritional deficiencies and socioeconomic disadvantages, predisposing to the development of frailty. More research is needed to agree an operational definition and optimal management strategies.
AB - Background:: Frailty is associated with a prodromal stage called pre-frailty, a potentially reversible and highly prevalent intermediate state before frailty becomes established. Despite being widely-used in the literature and increasingly in clinical practice, it is poorly understood. Objective:: To establish consensus on the construct and approaches to diagnose and manage pre-frailty. Methods:: We conducted a modified (electronic, two-round) Delphi consensus study. The questionnaire included statements concerning the concept, aspects and causes, types, mechanism, assessment, consequences, prevention and management of pre-frailty. Qualitative and quantitative analysis methods were employed. An agreement level of 70% was applied. Results:: Twenty-three experts with different backgrounds from 12 countries participated. In total, 70 statements were circulated in Round 1. Of these, 52.8% were accepted. Following comments, 51 statements were re-circulated in Round 2 and 92.1% were accepted. It was agreed that physical and non-physical factors including psychological and social capacity are involved in the development of pre-frailty, potentially adversely affecting health and health-related quality of life. Experts considered pre-frailty to be an age-associated multi-factorial, multi-dimensional, and non-linear process that does not inevitably lead to frailty. It can be reversed or attenuated by targeted interventions. Brief, feasible, and validated tools and multidimensional assessment are recommended to identify pre-frailty. Conclusions:: Consensus suggests that pre-frailty lies along the frailty continuum. It is a multidimensional risk-state associated with one or more of physical impairment, cognitive decline, nutritional deficiencies and socioeconomic disadvantages, predisposing to the development of frailty. More research is needed to agree an operational definition and optimal management strategies.
KW - Consensus
KW - Definition
KW - Delphi
KW - Frailty
KW - Geriatric assessment
KW - Older people
KW - Pre-frailty
KW - 2023 OA procedure
UR - http://www.scopus.com/inward/record.url?scp=85120965170&partnerID=8YFLogxK
U2 - 10.1016/j.archger.2021.104586
DO - 10.1016/j.archger.2021.104586
M3 - Article
C2 - 34896797
AN - SCOPUS:85120965170
VL - 99
JO - Archives of Gerontology and Geriatrics
JF - Archives of Gerontology and Geriatrics
SN - 0167-4943
M1 - 104586
ER -