Institute of General Practice, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany.
Department of Geriatrics, Neurosciences and Orthopaedics, Teaching Hospital "Agostino Gemelli", L.go A. Gemelli 8, 00168 Rome, Italy.
Eur J Intern Med. 2018 Oct;56:3-10. doi: 10.1016/j.ejim.2018.04.023. Epub 2018 May 31.
One of the major threats looming over the growing older population is frailty. It is a distinctive health state characterised by increased vulnerability to internal and external stressors. Although the presence of frailty is well acknowledged, its concept and operationalisation are hampered by the extraordinary phenotypical and biological complexity. Yet, a widely accepted conception is needed to offer tailored policies and approaches. The ADVANTAGE Group aims to analyse the diverse frailty concepts to uncover the essence of frailty as a basis for a shared understanding.
A systematic literature review was performed on frailty concepts and definitions from 2010 onwards. Eligible publications were reviewed using concept analysis that led to the extraction of text data for the themes "definition", "attributes", "antecedents", "consequences", and "related concepts". Qualitative description was used to further analyse the extracted text passages, leading to inductively developed categories on the essence of frailty.
78 publications were included in the review, and 996 relevant text passages were extracted for analysis. Five components constituted a comprehensive definition: vulnerability, genesis, features, characteristics, and adverse outcomes. Each component is described in more detail by a set of defining and explanatory criteria. An underlying functional perspective of health or its impairments is most compatible with the entity of frailty.
The recent findings facilitate a focus on the relevant building blocks that define frailty. They point to the commonalities of the diverse frailty concepts and definitions. Based on these components, a widely accepted broad definition of frailty comes into range.
日益老龄化的人口面临的主要威胁之一是虚弱。这是一种独特的健康状态，其特征是对外界和内部压力源的易感性增加。尽管虚弱的存在已得到广泛承认，但由于其表现型和生物学的复杂性，其概念和操作化受到阻碍。然而，需要一个广泛接受的概念来提供量身定制的政策和方法。ADVANTAGE 小组旨在分析不同的虚弱概念，以揭示虚弱的本质，作为共同理解的基础。
从 2010 年开始，对虚弱概念和定义进行了系统的文献回顾。使用概念分析对符合条件的出版物进行了审查，这导致了提取主题为“定义”、“属性”、“前因”、“后果”和“相关概念”的文本数据。使用定性描述进一步分析提取的文本段落，从而得出关于虚弱本质的归纳性发展类别。
该综述纳入了 78 篇出版物，提取了 996 个相关的文本段落进行分析。5 个组成部分构成了一个全面的定义：脆弱性、起源、特征、特征和不良后果。每个组成部分都通过一组定义和解释性标准进行了更详细的描述。健康或其损伤的潜在功能视角与虚弱的实体最吻合。
最近的发现有助于关注定义虚弱的相关构建块。它们指出了不同虚弱概念和定义的共同点。基于这些组成部分，一个广泛接受的虚弱的广义定义即将出现。
