Psychological frailty in older adults: a systematic scoping review

Background Psychological frailty, along with physical and cognitive frailty, is linked to an increased risk of negative health outcomes among older adults. However, the definition of psychological frailty has received limited attention. A thorough comprehension of the concept of psychological frailty is therefore required. Objectives To review existing definitions of psychological frailty and to provide a comprehensive overview of the concept of psychological frailty and associated measurements. Methods This review followed the PRISMA guidelines for scoping reviews and the JBI Manual for Evidence Synthesis. Eligibility criteria were developed based on the Participants-Concept-Context (PCC) framework. We searched CINAHL, Scopus, PubMed, Web of Science, and PsycINFO databases and other sources for relevant studies published between January 2003 to March 2022. Results The final scoping review included 58 studies. 40 (69%) of these studies provided a definition of psychological frailty and 7 studies provided a novel definition. The other 11 studies focused on components of defining psychological frailty. To better characterize psychological frailty, we propose four groups of components, including mood, cognitive, mental health, and fatigue-associated problems. We identified 28 measuring tools across studies and the Tilburg frailty indicator was the most frequently used (46.6% of studies). Conclusions Psychological frailty is a complex concept that lacks a consensus definition. It should include both psychological features and physical frailty. Depression and other psychological problems are commonly used to define psychological frailty. This scoping review outlines future research directions to refine the concept of psychological frailty.