The lived experience of frailty: beyond classification and towards a holistic understanding of health

• Published in: European geriatric medicine 2024-04, Vol.15 (2), p.435-444
• Main Authors: Chenhuichen, Chenhui, O’Halloran, Aisling M., Lang, Deirdre, Kenny, Rose Anne, Romero-Ortuno, Roman
• Format: Article
• Language: English
• Subjects: Geriatrics/Gerontology; Internal Medicine; Medicine; Medicine & Public Health; Research Paper
• ISSN: 1878-7649; 1878-7657; 1878-7657
• DOI: 10.1007/s41999-023-00909-4

Key summary points Aim We cross-sectionally described measured characteristics and lived experiences of older adults classified as frail by three different scales in The Irish Longitudinal Study on Ageing (TILDA). Findings Despite being classified as frail, more than 60% rated their health positively, and over 77% engaged in active leisure activities at least once a month. Message This study challenges the excessively negative perceptions of frailty, underscoring the need for a holistic understanding of frailty beyond classification scales. Purpose Frailty is characterised by decreased physiological reserves and vulnerability to stressors. Although scales, such as the Fried’s Frailty Phenotype (FP), Frailty Index (FI), and Clinical Frailty Scale (CFS), are used to identify frailty, the lived experience of frailty remains understudied. Methods This cross-sectional observational research involved participants aged 65 years and older from Wave 1 of The Irish Longitudinal Study on Ageing (TILDA). Participants were categorised into four independent groups: three frail groups based on the aforementioned scales and a non-frail group. Quantitative variables, including self-rated health, CASP-19 quality-of-life score, and frequency of social activities, were analysed and described. Results The study encompassed 1999 participants with an average age of 72 years, of whom 51% were women. FP exclusively identified 1.6% as frail ( n  = 32), FI 11.7% ( n  = 233), and CFS 6.8% ( n  = 135). More than 60% of all those classified as frail reported their health as good, very good, or excellent, with the lowest proportion (64%) being among frail by FI participants. Frail by FI participants exhibited the lowest mean average CASP-19 score, yet it remained relatively high at 39 out of 57 points. Over 77% of all frail individuals engaged in active leisure activities at least once a month. Conclusion This study underscores the need to comprehend frailty holistically beyond its mere identification. It challenges the prevailing belief that frailty inevitably leads to impaired quality of life and limited social engagement. The findings advocate for a reassessment of how both the general public and healthcare professionals perceive frailty.