Braude Philip, Lewis Emma Grace, Broach Kc Steve, Carlton Edward, Rudd Sarah, Palmer Jean, Walker Richard, Carter Ben, Benger Jonathan
University of the West of England, School of Health and Social Wellbeing, Bristol, UK; Collaborative Ageing Research (CLARITY) group, North Bristol NHS Trust, Bristol, UK; Research in Emergency Care, Avon Collaborative Hub (REACH), Bristol, UK.
AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK; NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Cumbria Northumberland Tyne and Wear NHS Foundation Trust and Faculty of Medical Sciences, Newcastle upon Tyne, UK.
Lancet Healthy Longev. 2025 Jan;6(1):100651. doi: 10.1016/j.lanhl.2024.100651. Epub 2025 Jan 10.
People living with frailty can experience discrimination, but unlike the characteristics of age and disability, frailty is not protected by law. Frailty is a clinical syndrome associated with ageing in which health deficits increase a person's vulnerability to illness, disability, and death. This scoping review, conducted by a team of methodologists, clinicians, lawyers, and patients, aimed to investigate the extent of discrimination against people living with frailty described in health-care literature. We searched five health-care databases from inception up to June, 2022, and grey literature, to identify 144 texts. The texts were classified by the types of discrimination (direct discrimination, indirect discrimination, harassment, and victimisation) and inductively developed into contextual themes. The median age of the participants was 77 years (IQR 69·9-82·0), and 65·4% were women. The most common types of discrimination were direct (in 90 [63%]), indirect (in 66 [46%]), and harassment (in one [1%]) of the 144 texts, with no instances of victimisation reported. Nine themes of discriminatory actions were developed. Discrimination against people living with frailty overlapped with discrimination based on established protected characteristics, including age, disability, race, and sex. Evidence indicated that frailty discrimination replaces, mediates, masks, and potentiates age discrimination. Discrimination against people with frailty seemed to be both an independent event and one that interacts with established protected characteristics. Future research should focus on preventing frailty-based discrimination and establishing whether frailty should be considered a new protected characteristic by law.
