Frailty in Young and Middle-Aged Adults: An Integrative Review

Area of Science:

• Gerontology
• Public Health
• Clinical Medicine

Background:

• Frailty is a significant public health concern in older adults, associated with adverse health outcomes and mortality.
• While frailty is well-documented in older populations, its prevalence and characteristics in younger adults (18-65 years) remain largely unexplored.
• Early identification and intervention for frailty may alter its trajectory, underscoring the need to understand it across the lifespan.

Purpose of the Study:

• To describe the prevalence, definitions, study designs, and contributing components of multidimensional frailty in adults aged 18 to 65.
• To provide guidance for future research, clinical practice, and policy development to benefit individuals experiencing frailty.
• To synthesize current knowledge on frailty in a younger demographic, identifying gaps and future directions.

Main Methods:

• An integrative review approach was employed to synthesize diverse methodologies and perspectives on frailty.
• Searches were conducted in CINAHL, Embase, PsycInfo, and PubMed for studies on frailty in adults aged 18 to 65.
• Studies published before 2010, non-English articles, and those not focused on frailty or from non-Western cultures were excluded.

Main Results:

• Twelve descriptive correlational studies met the inclusion criteria; no intervention or qualitative studies were identified.
• A standardized conceptual definition of frailty was not found across the included studies.
• Frailty was studied in populations with health disparities and chronic conditions, most commonly HIV. Prevalence varied widely, from 3.9% to 63%.
• Numerous factors associated with frailty were identified across physical, social, and psychological domains.

Conclusions:

• A universal definition and a multidimensional assessment tool for frailty are essential for future research in young and middle-aged adults.
• Early identification of frailty by clinicians can support targeted interventions to prevent or mitigate progression.
• Further research is crucial, as risk factors for frailty in younger populations may differ significantly from those in older adults.