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Social frailty: the importance of social and environmental factors in predicting frailty in older adults

02 October 2019
Volume 24 · Issue 10

Abstract

Frailty can have multifaceted contributors, including physical, psychological, social and environmental elements. There is a lack of clarity surrounding frailty as it lacks a universal common definition, multiple factors are attributed to frailty and no definitive assessment tool is available. The evidence suggests that there is a lack of research to indicate causal relationships between the various determinants of frailty in ageing individuals. This review discusses the important role that social and environmental factors play in predicting the risk of frailty in older adults, as well as discussing the various signs of frailty. Health professionals in primary and community care settings are well placed to prevent and identify social frailty in the persons they care for.

Frailty has always existed; it was featured in Shakespeare's As you Like It (Abbott and Dykes, 2017) and described in the 1980s as ‘failure to thrive’ (Jamison, 1997). However, an established universal definition of frailty is lacking (Berrut et al, 2013; Morley et al, 2013; Waldon, 2018). The British Geriatric Society (BGS) (2014) describes frailty as how, over time, a person's inner reserve and strength is gradually depleted. Their response to a relatively minor physical or mental stressor is excessive to how a person without frailty would respond. A minor infection, medication or environmental change may cause an adverse response, such as delirium or immobility (Turner and Clegg, 2014), hospitalisation or even death (Garre-Olmo et al, 2013; Morley et al, 2013).

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