Frailty Clinical Phenotype: A Physical and Cognitive Point of View

Abstract

Frailty is recognized as a clinical geriatric syndrome used to describe the weakest or most vulnerable older adults. Although the term frailty is commonly used in clinical practice, and the theoretical phenomenon is well accepted, it remains an evolving concept that lacks a universally accepted definition and specific diagnostic criteria. Different perspectives on frailty have led to two distinct viewpoints of this phenomenon in the literature. The first describes the phenomenon based solely on physical attributes and capabilities. In contrast, more recent perspectives describe the phenomenon in broader, multidimensional terms by incorporating the concept of cognitive frailty. In support of this view, there is increasing evidence that consideration of both cognitive and physical factors can better improve the ability to predict adverse health outcomes among frail older adults over physical factors alone. The recent recognition of the importance of cognitive factors has increased the complexity of this phenomenon and difficulty in developing a consensus definition. To add to this challenge, frailty can present in different stages of severity (from mild to severe), and there appears to be a dynamic relationship between these stages. Despite these challenges, a consensus on an international definition of frailty including physical and cognitive criteria is essential in order to advance research and treatment of this condition.