Axelle Costenoble1,2, Veerle Knoop1,2, Sofie Vermeiren1,2, Roberta Azzopardi Vella1,2, Aziz Debain1,2,3, Gina Rossi4, Ivan Bautmans1,2,3, Dominique Verté1,5, Ellen Gorus1,2,3, Patricia De Vriendt1,2,6. 1. Frailty in Ageing (FRIA) Research Department, Belgium. 2. Gerontology Department, Vrije Universiteit Brussel (VUB), Belgium. 3. Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Belgium. 4. Personality and Psychopathology Research Group, Faculty of Psychology and Educational Sciences, Belgium. 5. Belgian Ageing Studies Research Group, Vrije Universiteit Brussel (VUB), Belgium. 6. Artevelde Hogeschool, Ghent, Belgium.
Abstract
BACKGROUND AND OBJECTIVES: The relationship between frailty and disability in activities of daily living (ADLs) can be seen in different ways, with disability being-to varying degrees-a characteristic, negative outcome, or predictor of frailty. This conflation of definitions is partly a result of the different frailty tools used in research. Aiming to provide a comprehensive overview, this systematic literature search analyzed (i) if, (ii) to what extent, and (iii) how ADLs are evaluated by frailty instruments. RESEARCH DESIGN AND METHODS: A search was performed in PubMed, Web of Knowledge, and PsycINFO to identify all frailty instruments, followed by categorization of the ADL items into basic (b-), instrumental (i-), and advanced (a-) ADLs. RESULTS: In total, 192 articles described 217 frailty instruments, from which 52.1% contained ADL items: 45.2% b-ADLs, 35.0% i-ADLs, and 10.1% a-ADLs. The most commonly included ADL items were bathing (b-ADLs); using transportation (i-ADLs); and semiprofessional work engagement in organized social life or leisure activities (a-ADLs). These instruments all had a multidomain origin (χ 2 = 122.4, p < .001). DISCUSSION AND IMPLICATIONS: Because 52.1% of all instruments included ADL items, the concepts of frailty and disability appear to be highly entangled. This might lead to circular reasoning, serious concerns regarding contamination, and invalid research results.
BACKGROUND AND OBJECTIVES: The relationship between frailty and disability in activities of daily living (ADLs) can be seen in different ways, with disability being-to varying degrees-a characteristic, negative outcome, or predictor of frailty. This conflation of definitions is partly a result of the different frailty tools used in research. Aiming to provide a comprehensive overview, this systematic literature search analyzed (i) if, (ii) to what extent, and (iii) how ADLs are evaluated by frailty instruments. RESEARCH DESIGN AND METHODS: A search was performed in PubMed, Web of Knowledge, and PsycINFO to identify all frailty instruments, followed by categorization of the ADL items into basic (b-), instrumental (i-), and advanced (a-) ADLs. RESULTS: In total, 192 articles described 217 frailty instruments, from which 52.1% contained ADL items: 45.2% b-ADLs, 35.0% i-ADLs, and 10.1% a-ADLs. The most commonly included ADL items were bathing (b-ADLs); using transportation (i-ADLs); and semiprofessional work engagement in organized social life or leisure activities (a-ADLs). These instruments all had a multidomain origin (χ 2 = 122.4, p < .001). DISCUSSION AND IMPLICATIONS: Because 52.1% of all instruments included ADL items, the concepts of frailty and disability appear to be highly entangled. This might lead to circular reasoning, serious concerns regarding contamination, and invalid research results.
Authors: Elisabeta Ioana Hiriscau; Elena-Cristina Buzdugan; Ligia-Ancuta Hui; Constantin Bodolea Journal: Int J Environ Res Public Health Date: 2022-02-17 Impact factor: 3.390