Searching for an operational definition of frailty: a Delphi method based consensus statement: the frailty operative definition-consensus conference project

Abstract

Background: There is no consensus regarding the definition of frailty for clinical uses.

Methods: 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.

Results: 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.

Conclusions: 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.

Figures

Figure 1.

Flow chart of the Delphi process.

Figure 2.

Methods and cutoff points to classify the statements according to the reached agreement.

Figure 3.

Rate of answer and status of the statements in the different stages of our Delphi process.