title: A Scoping Review of Frailty and Acute Care in Middle-Aged and Older Individuals with Recommendations for Future Research.
abstract: There is general agreement that frailty is a state of heightened vulnerability to stressors arising from impairments in multiple systems leading to declines in homeostatic reserve and resiliency, but unresolved issues persist about its detection, underlying pathophysiology, and relationship with aging, disability, and multimorbidity. A particularly challenging area is the relationship between frailty and hospitalization. Based on the deliberations of a 2014 Canadian expert consultation meeting and a scoping review of the relevant literature between 2005 and 2015, this discussion paper presents a review of the current state of knowledge on frailty in the acute care setting, including its prevalence and ability to both predict the occurrence and outcomes of hospitalization. The examination of the available evidence highlighted a number of specific clinical and research topics requiring additional study. We conclude with a series of consensus recommendations regarding future research priorities in this important area.
authors.affiliation: Geriatric Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: David B
authors.initials: DB
authors.lastname: Hogan
authors.affiliation: Schools of Pharmacy and Public Health & Health Systems, University of Waterloo, Waterloo, ON, Canada.
authors.forename: Colleen J
authors.initials: CJ
authors.lastname: Maxwell
authors.affiliation: Division of Cardiology, McGill University, Montreal, QC, Canada.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Afilalo
authors.affiliation: Department of Surgery Anesthesia & Peri-operative Medicine and Physiology & Pathophysiology, University of Manitoba, Winnipeg, MB, Canada.
authors.forename: Rakesh C
authors.initials: RC
authors.lastname: Arora
authors.affiliation: Division of Critical Care Medicine, University of Alberta, Edmonton, AB, Canada.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Bagshaw
authors.affiliation: Division of Geriatric Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
authors.forename: Jenny
authors.initials: J
authors.lastname: Basran
authors.affiliation: Department of Family Medicine, McGill University, Montréal, QC, Canada.
authors.forename: Howard
authors.initials: H
authors.lastname: Bergman
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Bronskill
authors.affiliation: University of Waterloo Library, Waterloo, ON, Canada.
authors.forename: Caitlin A
authors.initials: CA
authors.lastname: Carter
authors.affiliation: Departments of Surgery, Oncology and Community Health Sciences, University of Calgary, Calgary, AB, Canada.
authors.forename: Elijah
authors.initials: E
authors.lastname: Dixon
authors.affiliation: Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, AB, Canada.
authors.forename: Brenda
authors.initials: B
authors.lastname: Hemmelgarn
authors.affiliation: Division of Geriatric Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Madden
authors.affiliation: Department of Medicine, Dalhousie University, Halifax, NS, Canada.
authors.forename: Arnold
authors.initials: A
authors.lastname: Mitnitski
authors.affiliation: Faculty of Medicine, University of Alberta, Edmonton, AB, Canada.
authors.forename: Darryl
authors.initials: D
authors.lastname: Rolfson
authors.affiliation: Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Henry T
authors.initials: HT
authors.lastname: Stelfox
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
authors.forename: Helen
authors.initials: H
authors.lastname: Tam-Tham
authors.affiliation: Department of Critical Care Medicine, Sunnybrook Hospital, Toronto, ON, Canada; Department of Anesthesia, University of Toronto, Toronto, ON, Canada.
authors.forename: Hannah
authors.initials: H
authors.lastname: Wunsch
keywords: acute care; assessment; frailty; hospitalization; outcomes