Searching for an Operational Definition of Frailty: A Delphi Method Based Consensus Statement. The Frailty Operative Definition-Consensus Conference Project

TLDR

Frailty lacks a universally accepted clinical definition, and further research is needed to establish an operative definition. The study aimed to reach consensus on a clinical definition of frailty using a modified Delphi method. Experts from diverse fields formed five focus groups, completed a questionnaire, and their responses were analyzed with a pre‑established strategy. Consensus was reached on screening frailty and identifying six core domains, yet only 44 % of concept statements and 18 % of diagnostic criteria statements achieved ≥80 % agreement, and no specific biomarkers were agreed upon.

Abstract

There is no consensus regarding the definition of frailty for clinical uses.A modified Delphi process was used to attempt to achieve consensus definition. Experts were selected from different fields and organized into five Focus Groups. A questionnaire was developed and sent to experts in the area of frailty. Responses and comments were analyzed using a pre-established strategy. Statements with an agreement more than or equal to 80% were accepted.Overall, 44% of the statements regarding the concept of frailty and 18% of the statements regarding diagnostic criteria were accepted. There was consensus on the value of screening for frailty and about the identification of six domains of frailty for inclusion in a clinical definition, but no agreement was reached concerning a specific set of clinical/laboratory biomarkers useful for diagnosis.There is agreement on the usefulness of defining frailty in clinical settings as well as on its main dimensions. However, additional research is needed before an operative definition of frailty can be established.