Frailty is an emerging global health burden, with major implications for clinical practice and public health. The prevalence of frailty is expected to rise alongside rapid growth in the ageing population. The course of frailty is characterised by a decline in functioning across multiple physiological systems, accompanied by an increased vulnerability to stressors.
Having frailty places a person at increased risk of adverse outcomes, including falls, hospitalisation, and mortality. Studies have shown a clear pattern of increased health-care costs and use associated with frailty. All older adults are at risk of developing frailty, although risk levels are substantially higher among those with comorbidities, low socioeconomic position, poor diet, and sedentary lifestyles. Lifestyle and clinical risk factors are potentially modifiable by specific interventions and preventive actions.
The concept of frailty is increasingly being used in primary, acute, and specialist care. However, despite efforts over the past three decades, agreement on a standard instrument to identify frailty has not yet been achieved. In this Series paper, we provide an overview of the global impact and burden of frailty, the usefulness of the frailty concept in clinical practice, potential targets for frailty prevention, and directions that need to be explored in the future.
The condition of frailty is gaining international attention as the population of older adults rises globally. Frailty is characterised by a decline in functioning across multiple physiological systems, accompanied by an increased vulnerability to stressors.1,2 It is associated with increased mortality, hospitalisation, falls, and admission to long- term care.1,2 There is also much individual burden for a person living with frailty, including impaired quality of life and loneliness.
The concept of frailty is constantly evolving in the literature, and there is a progressive debate about how to define the condition.5 This debate aside, three important factors have remained consistent over the past decades in the conceptualisation of frailty.G First, frailty is multidimensional, with physical and psychosocial factors playing a part in its development. Second, although its prevalence does increase with age, frailty is an extreme consequence of the normal ageing process. Third, frailty is dynamic, which means that an individual can fluctuate between states of severity of frailty.