title: Interventions for preventing, delaying the onset, or decreasing the burden of frailty: an overview of systematic reviews.
abstract: BACKGROUND
  Many systematic reviews have evaluated the effectiveness of interventions to prevent, delay, or decrease frailty symptoms, but no effort has been made to identify, map, and synthesize the findings from reviews across the full spectrum of interventions. Our objectives are to (1) synthesize findings from all existing systematic reviews evaluating interventions for preventing, delaying the onset, or decreasing the burden of frailty symptoms; (2) examine different conceptualizations of frailty that have been used in the development and implementation of interventions; and (3) inform policy by convening a stakeholder dialogue with Canadian health-system leaders.
  
  
  METHODS
  We will conduct an overview of systematic reviews to identify and synthesize all of the systematic reviews addressing interventions to preventing, delaying the onset, or decreasing the burden of frailty symptoms. To identify relevant systematic reviews, we will conduct database searches for published and grey literature as well as contact key experts and search reference lists of included reviews. Two reviewers will independently review all search results for inclusion and then conceptually map, extract key findings (including the conceptualization/definition of frailty used) and assess the methodological quality of all included reviews. We will then synthesize the findings by producing a 'gap map' (i.e. mapping reviews in a matrix according to the interventions and outcomes assessed), and narratively synthesize the key messages across reviews related to type of interventions.
  
  
  CONCLUSIONS
  Following the completion of the synthesis, we will use the findings to develop an evidence brief that mobilizes the best available evidence about the problem related to preventing, delaying the onset, or decreasing the burden of frailty symptoms in older adults, policy and programmatic options to address the problem and implementation considerations. The evidence brief will then be used as the input into a stakeholder dialogue, which will engage 18-22 Canadian health-system leaders (including policymakers, health providers, researchers, and other stakeholders) in 'off-the-record' deliberations to inform future actions and policymaking.
  
  
  BACKGROUND
  PROSPERO CRD42015022082.
authors.affiliation: McMaster Health Forum, McMaster University, Hamilton, Canada. wilsom2@mcmaster.ca.|Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Canada. wilsom2@mcmaster.ca.|Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada. wilsom2@mcmaster.ca.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Wilson
authors.affiliation: Département d'administration de la santé, École de santé publique, Université de Montréal, Montréal, Canada. francois.beland@umontreal.ca.|Institut Lady Davis, Hôpital général juif, Montréal, Canada. francois.beland@umontreal.ca.
authors.forename: François
authors.initials: F
authors.lastname: Béland
authors.affiliation: Institut Lady Davis, Hôpital général juif, Montréal, Canada. dominic.julien@mail.mcgill.ca.|Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Université de Montréal, Montréal, Canada. dominic.julien@mail.mcgill.ca.|Département de psychologie, Université de Montréal, Montréal, Canada. dominic.julien@mail.mcgill.ca.
authors.forename: Dominic
authors.initials: D
authors.lastname: Julien
authors.affiliation: Department of Social and Preventive Medicine at the Université de Montréal, Montréal, Canada. lise.gauvin.2@umontreal.ca.
authors.forename: Lise
authors.initials: L
authors.lastname: Gauvin
authors.affiliation: Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Canada. emmanuel.guindon@mcmaster.ca.|Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada. emmanuel.guindon@mcmaster.ca.
authors.forename: G Emmanuel
authors.initials: GE
authors.lastname: Guindon
authors.affiliation: l'Institut National d'Excellence en Santé et en Services Sociaux, Québec, Canada. denis.roy@inesss.qc.ca.
authors.forename: Denis
authors.initials: D
authors.lastname: Roy
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada. kcampbe@mcmaster.ca.|Programs for Assessment of Technology in Health (PATH), McMaster University, Hamilton, Canada. kcampbe@mcmaster.ca.
authors.forename: Kaitryn
authors.initials: K
authors.lastname: Campbell
authors.affiliation: Department of Health and Wellness, Halifax, NS, Canada. Donna.G.Comeau@novascotia.ca.
authors.forename: Donna G
authors.initials: DG
authors.lastname: Comeau
authors.affiliation: British Columbia Ministry of Health, Victoria, Canada. Heather.Davidson@gov.bc.ca.
authors.forename: Heather
authors.initials: H
authors.lastname: Davidson
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada. praina@mcmaster.ca.|McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Canada. praina@mcmaster.ca.
authors.forename: Parminder
authors.initials: P
authors.lastname: Raina
authors.affiliation: Erie St. Clair Local Health Integration Network, Chatham, Canada. Deborah@DeborahSattler.ca.
authors.forename: Deborah
authors.initials: D
authors.lastname: Sattler
authors.affiliation: School of Rehabilitation Science, McMaster University, Hamilton, Canada. vrkljan@mcmaster.ca.
authors.forename: Brenda
authors.initials: B
authors.lastname: Vrkljan
mesh_terms: D000368:Aged; D000375:Aging; D035843:Biomedical Research; D017281:Cost of Illness; D016330:Frail Elderly; D005853:Geriatrics / Q000379:methods*; D006801:Humans; D012196:Review Literature as Topic; D057170:Translational Research, Biomedical