Definitions of Frailty in Qualitative Research: A Qualitative Systematic Review

Area of Science:

• Gerontology
• Qualitative Research Methodology
• Health Sciences

Background:

• Frailty is a complex, multidimensional construct impacting older adults.
• Understanding the lived experience of frailty requires clear participant selection criteria.
• Existing qualitative research on frailty lacks consistent definitions and operationalization.

Purpose of the Study:

• To systematically review how frailty is defined in qualitative research on community-living frail older adults.
• To examine conceptual and operational definitions used for participant inclusion.
• To identify inconsistencies and potential biases in frailty assessment within qualitative studies.

Main Methods:

• Qualitative systematic review of 25 studies from six electronic databases (1994-2019).
• Data extraction focused on frailty definitions within study aims, background, literature review, methods, and sampling.
• Content analysis and concept mapping used for data synthesis; quality appraisal assessed potential researcher bias.

Main Results:

• Frailty generally defined as a biopsychosocial construct with loss of resilience and vulnerability.
• Most studies used subjective assessments (age, physical impairments) for participant inclusion, with limited consistency in objective measures.
• 13 studies (52%) showed potential bias due to insufficient reporting on recruitment, sampling, and researcher-participant relationships.

Conclusions:

• Predominance of age and physical limitations as criteria questions participant frailty status.
• Lack of clear, standardized frailty criteria and reliance on subjective assessment risk bias and limit findings' validity and transferability.
• Standardized reporting of frailty definitions and assessment methods is crucial for future metasynthesis and clinical application.