Frailty in a Post-Acute Care Population: A Scoping Review

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Health Services Research

Background:

• Frailty is a significant and escalating concern across the healthcare continuum.
• Understanding frailty within post-acute care (PAC) settings remains limited.
• This gap necessitates a focused review of current evidence.

Purpose of the Study:

• To conduct a scoping review summarizing evidence on frailty's impact on outcomes in PAC.
• To identify and synthesize frailty mitigation strategies implemented in PAC settings.

Main Methods:

• A comprehensive search of three major publication databases was performed.
• The search covered literature from January 2000 to June 2017.
• Eighteen articles specifically addressing frailty in PAC were identified and analyzed.

Main Results:

• Identified themes included frailty measurement scales, factors contributing to adverse outcomes/frailty diagnosis, and interventions.
• Frailty assessment scales predominantly focused on physical factors, with limited inclusion of nutrition and social support.
• Functional decline, grip strength, gait speed, polypharmacy, and nutrition were key factors linked to frailty and poor outcomes.

Conclusions:

• Current frailty assessments in PAC require a more multidimensional approach, incorporating nutrition and social determinants.
• Frailty characteristics significantly impede patients' ability to benefit from rehabilitation.
• Intervention studies yielded mixed results, indicating a need for further research and development in frailty mitigation strategies within PAC.