Interplay Between Multidimensional Frailty and Chronic Diseases: A Review

Despite the clinical emphasis placed on its physical characteristics, frailty remains a multidimensional, biopsychosocial disease which is directly associated with multimorbidity in community-dwelling older adults. Multimorbidity is further linked with increased mortality, declines in physical functioning, and polypharmacy amongst this patient population. In this vein, individual and pathophysiologically interconnected chronic diseases may drive multidimensional frailty. Studies exploring these associations, however, have primarily focused on frailty’s physical operationalisation.

This study investigated the associations between multidimensional frailty and six chronic diseases: diabetes mellitus, cancer, hypertension, arthrosis, urinary incontinence, and severe back disorder. To do so, it diffused the Tilburg Frailty Indicator (TFI), a user-friendly self-report questionnaire assessing biopsychosocial frailty, to a large cohort of Dutch older adults.

Key learnings:

The analysed chronic diseases displayed the strongest associations with total and physical frailty. Only hypertension, urinary incontinence, arthrosis, and severe back disorder were associated with all biopsychosocial variables underpinning multidimensional frailty. Urinary incontinence and severe back disorder displayed the strongest associations with multidimensional frailty, a finding with implications for the management of affected patients. Lastly, no synergy was noted between chronic diseases with regard to frailty development and progression.

Reviewed by: S. Duarte