. 2017 Mar 31;20(1):22-37.

doi: 10.5770/cgj.20.240. eCollection 2017 Mar.

A Scoping Review of Frailty and Acute Care in Middle-Aged and Older Individuals with Recommendations for Future Research

David B Hogan¹, Colleen J Maxwell², Jonathan Afilalo³, Rakesh C Arora⁴, Sean M Bagshaw⁵, Jenny Basran⁶, Howard Bergman⁷, Susan E Bronskill⁸, Caitlin A Carter⁹, Elijah Dixon¹⁰, Brenda Hemmelgarn¹¹, Kenneth Madden¹², Arnold Mitnitski¹³, Darryl Rolfson¹⁴, Henry T Stelfox¹⁵, Helen Tam-Tham¹⁶, Hannah Wunsch¹⁷

Affiliations

¹ Geriatric Medicine, University of Calgary, Calgary, AB, Canada.
² Schools of Pharmacy and Public Health & Health Systems, University of Waterloo, Waterloo, ON, Canada.
³ Division of Cardiology, McGill University, Montreal, QC, Canada.
⁴ Department of Surgery Anesthesia & Peri-operative Medicine and Physiology & Pathophysiology, University of Manitoba, Winnipeg, MB, Canada.
⁵ Division of Critical Care Medicine, University of Alberta, Edmonton, AB, Canada.
⁶ Division of Geriatric Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
⁷ Department of Family Medicine, McGill University, Montréal, QC, Canada.
⁸ Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
⁹ University of Waterloo Library, Waterloo, ON, Canada.
¹⁰ Departments of Surgery, Oncology and Community Health Sciences, University of Calgary, Calgary, AB, Canada.
¹¹ Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, AB, Canada.
¹² Division of Geriatric Medicine, University of British Columbia, Vancouver, BC, Canada.
¹³ Department of Medicine, Dalhousie University, Halifax, NS, Canada.
¹⁴ Faculty of Medicine, University of Alberta, Edmonton, AB, Canada.
¹⁵ Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada.
¹⁶ Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
¹⁷ Department of Critical Care Medicine, Sunnybrook Hospital, Toronto, ON, Canada; Department of Anesthesia, University of Toronto, Toronto, ON, Canada.

PMID: 28396706
PMCID: PMC5383404
DOI: 10.5770/cgj.20.240

A Scoping Review of Frailty and Acute Care in Middle-Aged and Older Individuals with Recommendations for Future Research

David B Hogan et al. Can Geriatr J. 2017.

. 2017 Mar 31;20(1):22-37.

doi: 10.5770/cgj.20.240. eCollection 2017 Mar.

Authors

Affiliations

¹ Geriatric Medicine, University of Calgary, Calgary, AB, Canada.
² Schools of Pharmacy and Public Health & Health Systems, University of Waterloo, Waterloo, ON, Canada.
³ Division of Cardiology, McGill University, Montreal, QC, Canada.
⁴ Department of Surgery Anesthesia & Peri-operative Medicine and Physiology & Pathophysiology, University of Manitoba, Winnipeg, MB, Canada.
⁵ Division of Critical Care Medicine, University of Alberta, Edmonton, AB, Canada.
⁶ Division of Geriatric Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
⁷ Department of Family Medicine, McGill University, Montréal, QC, Canada.
⁸ Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
⁹ University of Waterloo Library, Waterloo, ON, Canada.
¹⁰ Departments of Surgery, Oncology and Community Health Sciences, University of Calgary, Calgary, AB, Canada.
¹¹ Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, AB, Canada.
¹² Division of Geriatric Medicine, University of British Columbia, Vancouver, BC, Canada.
¹³ Department of Medicine, Dalhousie University, Halifax, NS, Canada.
¹⁴ Faculty of Medicine, University of Alberta, Edmonton, AB, Canada.
¹⁵ Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada.
¹⁶ Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
¹⁷ Department of Critical Care Medicine, Sunnybrook Hospital, Toronto, ON, Canada; Department of Anesthesia, University of Toronto, Toronto, ON, Canada.

PMID: 28396706
PMCID: PMC5383404
DOI: 10.5770/cgj.20.240

Abstract

There is general agreement that frailty is a state of heightened vulnerability to stressors arising from impairments in multiple systems leading to declines in homeostatic reserve and resiliency, but unresolved issues persist about its detection, underlying pathophysiology, and relationship with aging, disability, and multimorbidity. A particularly challenging area is the relationship between frailty and hospitalization. Based on the deliberations of a 2014 Canadian expert consultation meeting and a scoping review of the relevant literature between 2005 and 2015, this discussion paper presents a review of the current state of knowledge on frailty in the acute care setting, including its prevalence and ability to both predict the occurrence and outcomes of hospitalization. The examination of the available evidence highlighted a number of specific clinical and research topics requiring additional study. We conclude with a series of consensus recommendations regarding future research priorities in this important area.

Keywords: acute care; assessment; frailty; hospitalization; outcomes.

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Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES The authors declare that no conflicts of interest exist.

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A Scoping Review of Frailty and Acute Care in Middle-Aged and Older Individuals with Recommendations for Future Research

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A Scoping Review of Frailty and Acute Care in Middle-Aged and Older Individuals with Recommendations for Future Research

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