A Scoping Review of Frailty and Acute Care in Middle-Aged and Older Individuals with Recommendations for Future Research

  • David B. Hogan University of Calgary
  • Colleen J. Maxwell University of Waterloo
  • Jonathan Afilalo McGill University
  • Rakesh C. Arora University of Manitoba
  • Sean M. Bagshaw University of Alberta
  • Jenny Basran University of Saskatchewan
  • Howard Bergman McGill University
  • Susan E. Bronskill Institute for Clinical Evaluative Sciences
  • Caitlin A. Carter University of Waterloo
  • Elijah Dixon University of Calgary
  • Brenda Hemmelgarn University of Calgary
  • Kenneth Madden University of British Columbia
  • Arnold Mitnitski Dalhousie University
  • Darryl Rolfson University of Alberta
  • Henry T. Stelfox University of Calgary
  • Helen Tam-Tham University of Calgary
  • Hannah Wunsch University of Toronto
Keywords: Frailty, Acute Care, Hospitalization, Outcomes, Assessment


There is general agreement that frailty is a state of heightened vulnerability to stressors arising from impairments in multiple systems leading to declines in homeostatic reserve and resiliency, but unresolved issues persist about its detection, underlying pathophysiology, and relationship with aging, disability, and multimorbidity. A particularly challenging area is the relationship between frailty and hospitalization. Based on the deliberations of a 2014 Canadian expert consultation meeting and a scoping review of the relevant literature between 2005 and 2015, this discussion paper presents a review of the current state of knowledge on frailty in the acute care setting, including its prevalence and ability to both predict the occurrence and outcomes of hospitalization. The examination of the available evidence highlighted a number of specific clinical and research topics requiring additional study. We conclude with a series of consensus recommendations regarding future research priorities in this important area.

Author Biographies

David B. Hogan, University of Calgary

MD, Professor and Brenda Strafford Chair in Geriatric Medicine

Colleen J. Maxwell, University of Waterloo
PhD, Professor Schools of Pharmacy and Public Health & Health Systems
Jonathan Afilalo, McGill University
MD, MSc, Division of Cardiology
Rakesh C. Arora, University of Manitoba
MD, Department of Surgery, Anesthesia & Peri-operative Medicine and Physiology & Pathophysiology
Sean M. Bagshaw, University of Alberta
MD, MSc, Division of Critical Care Medicine
Jenny Basran, University of Saskatchewan
MD, Division of Geriatric Medicine
Howard Bergman, McGill University
MD, Department of Family Medicine
Susan E. Bronskill, Institute for Clinical Evaluative Sciences
PhD, Institute for Clinical Evaluative Sciences [ICES]
Caitlin A. Carter, University of Waterloo
HBA, MLIS, School of Pharmacy
Elijah Dixon, University of Calgary
MD MSc, Departments of Surgery, Oncology & Community Health Sciences
Brenda Hemmelgarn, University of Calgary
MD PhD, Departments of Medicine and Community Health Sciences
Kenneth Madden, University of British Columbia
MSc MD, Division of Geriatric Medicine
Arnold Mitnitski, Dalhousie University
PhD, Department of Medicine
Darryl Rolfson, University of Alberta
MD, Faculty of Medicine
Henry T. Stelfox, University of Calgary
MD PhD, Department of Critical Care Medicine
Helen Tam-Tham, University of Calgary
MSc, Department of Community Health Sciences
Hannah Wunsch, University of Toronto
MD MSc, Department of Critical Care Medicine, Sunnybrook Hospital and Department of Anesthesia, University of Toronto
How to Cite
Hogan, D. B., Maxwell, C. J., Afilalo, J., Arora, R. C., Bagshaw, S. M., Basran, J., Bergman, H., Bronskill, S. E., Carter, C. A., Dixon, E., Hemmelgarn, B., Madden, K., Mitnitski, A., Rolfson, D., Stelfox, H. T., Tam-Tham, H., & Wunsch, H. (2017). A Scoping Review of Frailty and Acute Care in Middle-Aged and Older Individuals with Recommendations for Future Research. Canadian Geriatrics Journal, 20(1). https://doi.org/10.5770/cgj.20.240