Elsevier

Nursing Outlook

Volume 58, Issue 2, March–April 2010, Pages 76-86
Nursing Outlook

Article
Toward a conceptual definition of frail community dwelling older people

https://doi.org/10.1016/j.outlook.2009.09.005Get rights and content

In order to be able to identify frail community-dwelling older people, a reliable and valid definition of the concept of frailty is necessary. The aim of this study was to provide an overview of the literature on conceptual and operational definitions of frailty, and to determine which definitions are most appropriate for identifying frail community-dwelling older people. Therefore, a computerized search was performed in the PubMed database, Web of Science and PsychInfo. A successful definition of frailty reflects a multidimensional approach, makes clear its dynamic state, predicts adverse outcomes, does not include disease, comorbidity or disability, and meets the criterion of practicability. None of the current conceptual and operational definitions meet these criteria. In this article a new integral conceptual definition of frailty is proposed which meets the criteria of a successful definition.

Section snippets

Method

Initially, a computer search was performed in the PubMed database, Web of Science and PsychInfo (up to December 2008). Combinations of the following subject headings and words were used: “frail” (and the related words “frail elderly” and “frailty”), “definition,” “conceptual framework,” “patient identification,” “community-dwelling,” and “risk factors.”

In addition, references cited in the articles were scanned to identify other relevant articles not found by the initial search.

A number of

Debate on Frailty

Frailty can be seen as increasing vulnerability associated with aging.13 Precisely how it should be defined remains unclear.1, 4, 14, 15 There is still a lack of consensus on a definition of frailty.16 However, there is an urgent need for consensus on the definition of frailty among healthcare professionals in order that the screening and treatment of frailty can be more effective.6, 17 The emphasis should be on those healthcare professionals such as general practitioners, nurse practitioners,

Discussion

This article aims to present a number of conceptual and operational definitions of frailty. At the beginning of the article it was acknowledged that there are numerous different definitions of frailty in circulation. The literature search made clear that 5 criteria should be used to determine the success of these definitions of frailty. A definition that meets these criteria contains a multidimensional approach; is dynamic; has predictive validity for adverse outcomes; does not include disease,

Robbert J. Gobbens, MSc, RN, is Lecturer at Avans University of Applied Sciences, Breda, The Netherlands; Researcher at Tranzo Academic Centre in Care and Welfare, Tilburg University, Tilburg, The Netherlands.

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  • Cited by (279)

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    Robbert J. Gobbens, MSc, RN, is Lecturer at Avans University of Applied Sciences, Breda, The Netherlands; Researcher at Tranzo Academic Centre in Care and Welfare, Tilburg University, Tilburg, The Netherlands.

    Katrien G. Luijkx, PhD, is Senior Researcher at Tranzo Academic Centre in Care and Welfare, Tilburg University, Tilburg, The Netherlands.

    Maria T. Wijnen-Sponselee, PhD, is Reader Gerontology at Avans University of Applied Sciences, Breda, The Netherlands.

    Jos M. Schols, PhD, MD, is Professor of Nursing Home Medicine at Caphri, Department General Practice, Maastricht University, Maastricht, The Netherlands; former Professor of Chronic Care at Tranzo Academic Centre in Care and Welfare, Tilburg University, Tilburg, The Netherlands.

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