What is the frailty in elderly? Value and significance of the multidimensional assessments.

Authors perform a critical revision of the concept of frailty in elderly going back to its first indication (1978). It is a particular phenotypic condition, characterized by advanced age, clinically unstable polypathologies in evolution, with cognitive disturbances, often very severe, loss of auto sufficiency and the critical socio-economic conditions. The diagnostic validity, both in the definition of the deficits and in the evaluation of the declines in the fundamental functions should be underlined. The first ones are needed particularly for the epidemiological and population studies, and the second one, at the individual level. Today, first of all in the geriatric field, the method of multidimensional evaluation (MDE) is the first choice for the early diagnosis of "elderly frailty" (EF), in order to determine the biological, functional, cognitive and clinical aspects of the elderly subjects, and also for the application of adequate programs of intervention at the sanitary-assistential-social levels.