A Comprehensive Overview of Activities of Daily Living in Existing Frailty Instruments: A Systematic Literature Search.

Assessment of Conditions/People Disabilities Frailty Review

Journal

The Gerontologist
ISSN: 1758-5341
Titre abrégé: Gerontologist
Pays: United States
ID NLM: 0375327

Informations de publication

Date de publication:
03 04 2021
Historique:
received: 15 05 2019
pubmed: 25 12 2019
medline: 22 4 2021
entrez: 25 12 2019
Statut: ppublish

Résumé

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. 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. 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). 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.

Sections du résumé

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.

Identifiants

pubmed: 31872238
pii: 5679755
doi: 10.1093/geront/gnz147
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

e12-e22

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Auteurs

Axelle Costenoble (A)

Frailty in Ageing (FRIA) Research Department, Belgium.
Gerontology Department, Vrije Universiteit Brussel (VUB), Belgium.

Veerle Knoop (V)

Frailty in Ageing (FRIA) Research Department, Belgium.
Gerontology Department, Vrije Universiteit Brussel (VUB), Belgium.

Sofie Vermeiren (S)

Frailty in Ageing (FRIA) Research Department, Belgium.
Gerontology Department, Vrije Universiteit Brussel (VUB), Belgium.

Roberta Azzopardi Vella (RA)

Frailty in Ageing (FRIA) Research Department, Belgium.
Gerontology Department, Vrije Universiteit Brussel (VUB), Belgium.

Aziz Debain (A)

Frailty in Ageing (FRIA) Research Department, Belgium.
Gerontology Department, Vrije Universiteit Brussel (VUB), Belgium.
Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Belgium.

Gina Rossi (G)

Personality and Psychopathology Research Group, Faculty of Psychology and Educational Sciences, Belgium.

Ivan Bautmans (I)

Frailty in Ageing (FRIA) Research Department, Belgium.
Gerontology Department, Vrije Universiteit Brussel (VUB), Belgium.
Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Belgium.

Dominique Verté (D)

Frailty in Ageing (FRIA) Research Department, Belgium.
Belgian Ageing Studies Research Group, Vrije Universiteit Brussel (VUB), Belgium.

Ellen Gorus (E)

Frailty in Ageing (FRIA) Research Department, Belgium.
Gerontology Department, Vrije Universiteit Brussel (VUB), Belgium.
Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Belgium.

Patricia De Vriendt (P)

Frailty in Ageing (FRIA) Research Department, Belgium.
Gerontology Department, Vrije Universiteit Brussel (VUB), Belgium.
Artevelde Hogeschool, Ghent, Belgium.

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