Objective: To identify and examine definitions of frailty using qualitative thematic analysis.
Design: A qualitative meta-aggregative systematic review.
Data Sources: The database search was performed using ASSIA, CINAHL, Cochrane Library, Embase, PsycINFO, PubMed and Google Scholar databases. Studies providing definitions of frailty, published in English from 1 January 2000 to 25 July 2018 were included.
Review Methods: Data were extracted by independent reviewers for qualitative thematic analysis.
Results: In total, 86 studies met inclusion criteria. Five major themes with specific sub-themes were identified following thematic analysis including: (1) types of definitions (operational, conceptual, theoretical, older adults' perspective); (2) characteristics of frailty (a multi-domain and dimensional state, deficits/decline, weakness, a continuum-dynamic concept, clinically identifiable); (3) associated factors (age, comorbidity, nutrition, sarcopenia, social networks and environment); (4) mechanism (reduced adaptability, hormonal dysregulation); and (5) changes in health status and adverse outcomes (disability, increased risk of mortality, other healthcare related outcomes such as increased dependency or risk of falls).
Conclusions: Several themes were found that defined frailty, focusing predominantly on operational definitions and frailty as a physical syndrome. A universally accepted standard definition, which includes all dimensions of frailty is currently warranted.
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