How can frailty in the elderly be defined?

A comprehensive, multidisciplinary and international approach

Adopting an international and multidisciplinary approach, MADoPA held its first seminar on the frailty of the elderly on 9 November 2010 in Paris. The aim of this seminar was to identify the various angles from which frailty might be analysed (in terms of public health, as a geriatric or medical syndrome), the different ways in which it might be defined (syndrome, risk, an intermediate state between independence and dependence, etc.) and its many different biomedical, social and economic aspects.
To begin with, the fundamentally biomedical notion of frailty was defined by two hospital practitioners, Professor François Blanchard from Reims Teaching Hospital, who spoke about “different levels of analysis of frailty”, and Professor Claude Jeandel from Montpellier Teaching Hospital, who spoke about “the physiopathological approach to frailty”.
Three reports were then presented to illustrate the diversity of approaches to the notion of frailty and the issues involved in defining and using it:

• Stéfano Cavalli, University of Geneva, “The SWILSOO study”,
• Valérie Luquet, CLEIRPPA, “The social aspects of frailty”,
• Professor François Béland, University of Montréal, “Frailty, bigger than its component parts”.

The notion of frailty was then put into perspective with that of vulnerability by Hervé Michel, who presented the “Results of the Vulage project”, with frailty providing insights “from the inside” on the state of weakness of an individual (based on the individual’s biomedical characteristics) and vulnerability providing insights on that state of weakness “from the outside” (i.e. from the point of view of an individual’s ability to adapt and adjust given his or her individual and relation-based resources).
A second seminar scheduled for 31 January 2011 will continue this thought process and address the question: “how can the frailty of the elderly be measured?”