Jananee Rasiah1, Greta G Cummings2, Andrea Gruneir3, Nelly D Oelke4, Carole Estabrooks5, Jayna Holroyd-Leduc6. 1. Faculty of Nursing, University of Alberta, 3-141 Edmonton Clinic Health Academy (ECHA), 11405 87 Avenue, Edmonton, AB Canada T6G 1C9. Electronic address: rasiah@ualberta.ca. 2. Faculty of Nursing, University of Alberta, 3-141 Edmonton Clinic Health Academy (ECHA), 11405 87 Avenue, Edmonton, AB Canada T6G 1C9. Electronic address: gretac@ualberta.ca. 3. Faculty of Medicine and Dentistry, University of Alberta, 6-10 University Terrace, University of Alberta, Edmonton, Alberta, Canada T6G 2R7. Electronic address: gruneir@ualberta.ca. 4. School of Nursing, Faculty of Health and Social Development, University of British Columbia, Okanagan, 1147 Research Road, Kelowna, BC Canada V1V 1V7. Electronic address: nelly.oelke@ubc.ca. 5. Faculty of Nursing, University of Alberta, 3-141 Edmonton Clinic Health Academy (ECHA), 11405 87 Avenue, Edmonton, AB Canada T6G 1C9. Electronic address: cestabrooks@ualberta.ca. 6. Departments of Medicine and Community Health Sciences, University of Calgary, 11th Floor South Tower, Room 1104, 1403-29 Street NW, Calgary, Alberta, Canada T2N 2T9. Electronic address: jayna.holroyd-leduc@ahs.ca.
Abstract
BACKGROUND: The concept of prefrailty lacks clarity. Often, prefrailty is defined in relation to frailty and less often as a distinct concept. Theoretical evidence for prefrailty is minimal unlike frailty, which has been examined for decades although consensus about how to measure frailty has not been achieved. OBJECTIVE: The aim of this study was to conduct a concept analysis of prefrailty to provide greater understanding of this phenomenon in the context of older adults. DESIGN: Rodgers and Knafl's evolutionary concept analysis approach. DATA SOURCES: The literature search for the concept analysis was conducted as follows: three databases (MEDLINE, CINAHL, and Abstracts in Social Gerontology databases) were searched using carefully selected search terms; and grey literature was not included. REVIEW METHODS: In phase one, we used the search strategy and search terms to narrow the search for relevant articles. We selected articles that met the following inclusion criteria: (1) how prefrailty was conceptualized; (2) how prefrailty was measured; and (3) interventions targeted towards prefrailty. In phase two, we extracted data from included articles. In phase three, we analyzed data using thematic analysis and findings were presented as attributes, antecedents, consequences, and related concepts of prefrailty. One example of prefrailty in older adults was presented to highlight the concept in praxis. In phase four, methodological and substantive area experts reviewed and contributed to discussion and interpretation of findings including disciplinary perspectives of prefrailty. RESULTS: A total of 41 articles were included for synthesis. The attributes of prefrailty were predisposing in nature, non-specific, multidimensional, and cumulative in effects. Antecedents of prefrailty were categorized into the following domains: sociodemographic characteristics, comorbidity, behaviours, and laboratory/clinical markers. Consequences of prefrailty were separated into two themes: increased risk of adverse outcomes and advancing levels of frailty. Surrogate and related terms (noted in the literature) that had shared attributes with prefrailty were increased vulnerability, transitional stage, dynamic process, progressive process with latent phase, and physical frailty. CONCLUSIONS: As a result of conducting this concept analysis, we found that prefrailty was defined as a clinically silent process that predisposes individuals to frailty. Prefrailty, as a concept, was derived from the Fried's operational definition for frailty. Attributes, antecedents, consequences, and related terms will help clinicians consider how prefrailty presents in older adults separate from frailty. Further research is needed to build upon our understanding from this concept analysis. Tweetable Abstract: Prefrailty is unclear as a concept - Research on sociodemographic characteristics of older adults living with frailty will help clarify.
BACKGROUND: The concept of prefrailty lacks clarity. Often, prefrailty is defined in relation to frailty and less often as a distinct concept. Theoretical evidence for prefrailty is minimal unlike frailty, which has been examined for decades although consensus about how to measure frailty has not been achieved. OBJECTIVE: The aim of this study was to conduct a concept analysis of prefrailty to provide greater understanding of this phenomenon in the context of older adults. DESIGN: Rodgers and Knafl's evolutionary concept analysis approach. DATA SOURCES: The literature search for the concept analysis was conducted as follows: three databases (MEDLINE, CINAHL, and Abstracts in Social Gerontology databases) were searched using carefully selected search terms; and grey literature was not included. REVIEW METHODS: In phase one, we used the search strategy and search terms to narrow the search for relevant articles. We selected articles that met the following inclusion criteria: (1) how prefrailty was conceptualized; (2) how prefrailty was measured; and (3) interventions targeted towards prefrailty. In phase two, we extracted data from included articles. In phase three, we analyzed data using thematic analysis and findings were presented as attributes, antecedents, consequences, and related concepts of prefrailty. One example of prefrailty in older adults was presented to highlight the concept in praxis. In phase four, methodological and substantive area experts reviewed and contributed to discussion and interpretation of findings including disciplinary perspectives of prefrailty. RESULTS: A total of 41 articles were included for synthesis. The attributes of prefrailty were predisposing in nature, non-specific, multidimensional, and cumulative in effects. Antecedents of prefrailty were categorized into the following domains: sociodemographic characteristics, comorbidity, behaviours, and laboratory/clinical markers. Consequences of prefrailty were separated into two themes: increased risk of adverse outcomes and advancing levels of frailty. Surrogate and related terms (noted in the literature) that had shared attributes with prefrailty were increased vulnerability, transitional stage, dynamic process, progressive process with latent phase, and physical frailty. CONCLUSIONS: As a result of conducting this concept analysis, we found that prefrailty was defined as a clinically silent process that predisposes individuals to frailty. Prefrailty, as a concept, was derived from the Fried's operational definition for frailty. Attributes, antecedents, consequences, and related terms will help clinicians consider how prefrailty presents in older adults separate from frailty. Further research is needed to build upon our understanding from this concept analysis. Tweetable Abstract: Prefrailty is unclear as a concept - Research on sociodemographic characteristics of older adults living with frailty will help clarify.
Authors: Marta Fernández Batalla; Enrique Monsalvo San Macario; Alexandra González Aguña; Sara Herrero Jaén; Blanca Gonzalo de Diego; Yolima Manrique Anaya; M Lourdes Jiménez Rodríguez; Estela Melguizo Herrera; José María Santamaría García Journal: Nurs Open Date: 2022-03-08