Sutton Jennifer L, Gould Rebecca L, Howard Robert J
Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Division of Psychiatry, University College London, London, UK.
Int J Geriatr Psychiatry. 2022 Jan;37(1). doi: 10.1002/gps.5642. Epub 2021 Oct 22.
Substantial construct overlap exists between indicators of frailty and symptoms of some psychiatric disorders. This study aimed to gain consensus of expert academic opinion on the potential impact of psychiatric illness on frailty assessment and how best to conceptualise and measure frailty indicators in the context of psychiatric symptoms.
A classic Delphi approach was employed across two studies to achieve consensus: The first-round questionnaire consisted of open-ended questions, analysed through content analysis. The results informed the development of statements for participants to rate their agreement with in subsequent Delphi rounds. Statements with ≥66% agreement were accepted. Delphi Study 1 recruited experts in frailty assessment (n = 13) and Delphi Study 2 recruited experts in frailty and psychiatric disorder (n = 8). Experts were recruited globally.
Overall, 40% of Delphi Study 1 statements and 43% of Delphi Study 2 statements were accepted. Primarily, consensus was reached for statements concerning the influence of depression/anxiety on frailty assessment and potential methods of conceptualising and measuring frailty indicators in the context of psychiatric symptoms. Little consensus was reached concerning the ease and importance of differentiating between frailty indicators and psychiatric assessment criteria with substantial overlap.
The Delphi studies provide a novel exploration and consensus of expert academic opinions concerning the assessment of frailty indicators in the context of psychiatric symptoms. The results will inform future research into the adaptation or development of a frailty assessment tool specifically for use in older adult psychiatric populations.
衰弱指标与某些精神障碍症状之间存在大量结构重叠。本研究旨在就精神疾病对衰弱评估的潜在影响以及如何在精神症状背景下最佳地概念化和测量衰弱指标达成专家学术意见的共识。
在两项研究中采用经典的德尔菲法以达成共识:第一轮问卷由开放式问题组成,通过内容分析进行分析。结果为后续德尔菲轮次中参与者对陈述的同意程度评分的陈述制定提供了依据。同意率≥66%的陈述被接受。德尔菲研究1招募了衰弱评估专家(n = 13),德尔菲研究2招募了衰弱和精神障碍专家(n = 8)。专家在全球范围内招募。
总体而言,德尔菲研究1中40%的陈述和德尔菲研究2中43%的陈述被接受。主要就关于抑郁/焦虑对衰弱评估的影响以及在精神症状背景下概念化和测量衰弱指标的潜在方法的陈述达成了共识。对于区分存在大量重叠的衰弱指标和精神评估标准的难易程度和重要性,几乎未达成共识。
德尔菲研究为在精神症状背景下评估衰弱指标的专家学术意见提供了新颖的探索和共识。研究结果将为未来专门用于老年精神科人群的衰弱评估工具的调整或开发研究提供参考。