Reaching a consensus on frailty
Researchers strive to understand what makes the elderly frail, a fact of life that bears strongly on productivity, economic output and healthcare. The study of frailty sheds light on why many older persons develop disabilities late in life, even if researchers can't agree on the definition of the concept. The EU-funded project 'Frailty operative definition - consensus conference' (FOD-CC) aimed to arrive at an inclusive definition of the concept – one that would also present a useful clinical profile. In its simplest form, frailty is an age-associated biological syndrome resulting in disability and hospitalisation. Within this definition lie many different layers pertaining to mental health, nutrition and decreased sexuality, which in turn are tied to a plethora of cultural, economic and ethnic considerations. Against this backdrop, the project team worked on evaluating consensus among experts on frailty, particularly regarding its clinical and diagnostic components. Using a communication technique known as the Delphi method, which is based on decisions of a structured group of individuals, the team produced over 130 statements to better define frailty. It clarified the difference between frailty and disability, reaching consensus on diagnosis and prognosis, as well as outlining biomarkers to identify frailty. Specifically, the team agreed that frailty is a dynamic, non-linear process that impacts multiple body systems, is characterised by diminished resistance to stress and can be considered a clinical syndrome. It is different from vulnerability and disability in that over and above its physical components, it involves a variety of psychological, social, emotional and spiritual elements. The project team also emphasised that nutritional status, physical performance, mental health and cognitive status are key components in assessing frailty. In parallel, significant progress has been made in identifying biomarkers for the diagnosis and prognosis of frailty, representing a very important step in preventing disability. This is expected to guide policymaking related to elderly people and their well-being, providing an instrument to help prevent, treat and reverse frailty. The project's outcomes will also enable researchers to measure the effectiveness of interventions that address frailty, contributing to a decline in frailty-related diseases and in costs related to disability and healthcare. These valuable findings and conclusions have been disseminated through international journals, the project website, workshops and congresses, reaching key events in Greece, Spain, Taiwan and the United States. Lastly, members of the project collaborated in the launching of a new scientific 'Journal of Frailty', which will help strengthen consensus on the topic and address the condition more effectively.
