Research Papers

If you are interested in learning more about the latest research associated with frailty and the way in which it is defined, experienced and managed then please explore our repository of academic research papers found below. If you are looking for a less in-depth perspective then you might also like to review our collection of public-facing reports on frailty.

Dr Ebrahim Mulla Academic Clinical Fellow, Leicester GP Training Programme
Dr Ursula Montgomery GP Partner and Chair, East Leicestershire Clinical Commissioning Group

Ageing well is ‘everyone’s concern’. However, everyone who ages does not necessarily live with frailty, and frailty is no respecter of age. This article is part of a series unravelling frailty. We draw upon the latest thinking, evidence and policy to explore the nature of frailty, why frailty matters and how GP services are developing to meet the challenge to better support people living with frailty.

Kevin F. Boreskie
Jacqueline L. Hay
Patrick E. Boreskie
Rakesh C. Arora
Todd A. Duhamel

Healthcare systems need to adapt to better serve an aging population with complex presentations. Frailty assessments are a potential means to address this heterogeneity in aging to identify individuals at increased risk for adverse health outcomes. Furthermore, frailty assessments ofer an opportunity to optimize patient care in various healthcare settings. While the vast number of frailty assessment tools available can be a source of confusion for clinicians, each tool has features adaptable to the constraints and goals of diferent healthcare settings. This review discusses and compares barriers, facilitators, and the application of frailty assessments in primary care, the emergency department/ intensive care unit and surgical care to cover a breadth of settings with diferent frailty assessment considerations. The implementation of frailty-aware care across healthcare settings potentiates better healthcare outcomes for older adults

Gotaro Kojima Department of Research, Dr. AGA Clinic, Tokyo, Japan
Yu Taniguchi
Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
Reijiro Aoyama
Department of Japanese Studies, The Chinese University of Hong Kong, Shatin, Hong Kong
Marianne Tanabe
Veterans Affairs Pacific Islands Health Care System, Honolulu, HI, USA

Older adults may be at increased risk of loneliness. Frailty is also common in older adults, however, associations between loneliness and frailty have been understudied. This systematic review and meta-analysis aimed to explore evidence on how loneliness and frailty are correlated. Methods: A systematic search of the literature was conducted using 4 electronic databases in February 2022 for any studies published in 2000 or later that provided cross-sectional or longitudinal associations between loneliness and physical frailty in community-dwelling older adults. A meta-analysis was attempted to combine data when possible.

Victoria Cluley University of London, Business School, 106 Bunhill Row, London EC1Y 8TZ, UK
Graham Martin
THIS Institute, University of Cambridge, UK
Zoe Radnor
University of London, UK
Jay Banerjee
Consultant in Emergency Medicine, University Hospitals of Leicester, UK

The clinical identification of frailty is increasingly thought to be important in countries with ageing populations. Understanding how older people labelled as frail make sense of this categorisation is therefore important. A number of recent studies have reported negative perceptions of the term among older people themselves. Building on this, we focus on how and why those assessed to be frail make sense of frailty as they do. We draw on 26a discourse analysis of situated interviews with 30 older people accessing emergency care in an English NHS hospital. Three interpretive repertoire pairs (Frailty is 26a bodily issue/frailty is about mind-set; Frailty is 26a negative experience/frailty is an inevitable experience; I’m not frail/I feel frail), identified across the participants’ talk, are outlined and discussed in relation to discourses of the fourth age and precarity. We conclude that frailty is often seen in terms what others have referred to as ‘real’ old age and is linked to discourses of dependence and precarity.

Grainne Vavasour , Oonagh M. Giggins , Julie Doyle and Daniel Kelly

Globally the population of older adults is increasing. It is estimated that by 2050 the number of adults over the age of 60 will represent over 21% of the world’s population. Frailty is a clinical condition associated with ageing resulting in an increase in adverse outcomes. It is considered the greatest challenge facing an ageing population afecting an estimated 16% of community-dwelling populations worldwide. The aim of this systematic review is to explore how wearable sensors have been used to assess frailty in older adults.

Nutrition and Frailty

Mary Ni Lochlainn, Natalie J. Cox, Thomas Wilson, Richard P. G. Hayhoe, Sheena E. Ramsay, Antoneta Granic, Masoud Isanejad, Helen C. Roberts, Daisy Wilson, Carly Welch, Christopher Hurst, Janice L. Atkins, Nuno Mendonça, Katy Horner, Esme R. Tuttiett, Yvie Morgan, Phil Heslop, Elizabeth A. Williams, Claire J. Steves, Carolyn Greig, John Draper, Clare A. Corish, Ailsa Welch, Miles D. Witham, Avan A. Sayer and Sian Robinson.

Frailty is a syndrome of growing importance given the global ageing population. While frailty is a multifactorial process, poor nutritional status is considered a key contributor to its pathophysiology. As nutrition is a modifiable risk factor for frailty, strategies to prevent and treat frailty should consider dietary change. Observational evidence linking nutrition with frailty appears most robust for dietary quality: for example, dietary patterns such as the Mediterranean diet appear to be protective. In addition, research on specific foods, such as a higher consumption of fruit and vegetables and lower consumption of ultra-processed foods are consistent, with healthier profiles linked to lower frailty risk. Few dietary intervention studies have been conducted to date, although a growing number of trials that combine supplementation with exercise training suggest a multidomain approach may be more effective. This review is based on an interdisciplinary workshop, held in November 2020, and synthesises current understanding of dietary influences on frailty, focusing on opportunities for prevention and treatment. Longer term prospective studies and well-designed trials are needed to determine the causal effects of nutrition on frailty risk and progression and how dietary change can be used to prevent and/or treat frailty in the future.

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