Variations in Frailty Perceptions between Patients and Physicians

"Frailty" is frequently used by healthcare professionals; however, self-perception of frailty, also known as "perceived frailty," remains ambiguous and subjective. Such perceptions by physicians influence the design of treatment plans; alternatively, patients' self-perception also affects their acceptance of said plans. We performed a literature review to evaluate differences in perceived frailty between physicians and patients.

A no-restriction, comprehensive literature search was conducted over 3 months in PubMed to identify relevant peer-reviewed studies, focussing on the concept of perceived frailty. Two independent reviewers screened the citations for inclusion. One reviewer then extracted and analysed the data descriptively to map the available evidence. Quantitative and qualitative syntheses were performed. We examined papers written on the topic of frailty and excluded those that did not assess for perceived frailty among patients or physicians. A total of 20 papers were included and data were extracted for N = 27,342 patients and physicians in aggregate. In the domain of physical frailty, more physicians perceived patients as frail (N = 1,262, 56.09%) compared to patients' self-perception (N = 1,004, 43.59%). Alternatively, more patients perceive themselves as socially frail (58.9%). Regarding ethnicity, most studies focused on Western cohorts (16 studies), followed by three Asian and one multiethnic cohort. Among the eligible studies, more patients in Asia consider themselves frail (N = 1,542, 58.93%) compared to the Western population (N = 1,004, 43.59%).

We observed differences in frailty perception between patients and physicians and across different domains. It would be insightful when used as the foundation for future targeted models of educational and communication strategies across multifaceted domains.