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Existing models of frailty were primarily developed in outpatient cohorts, and are therefore challenging to apply to an inpatient population [ 10- 13].
Other distinct conceptual models of frailty have also been proposed, which are extensively reviewed elsewhere and will not be discussed here.
Key components of several multidimensional models of frailty, such as economic vulnerability, may act as determinants, as enhancers, or as outcomes of frailty.
The comparison of studies on the prevalence of frailty is hindered by the innumerous diagnostic models of frailty as well as the different locations where the evaluations took place.
For example, Mezuk et al 14 demonstrated that models of frailty and depression with differing numbers of classes (two in frailty; three in depression) that represent severity provided a better fit to their data, but that the constructs shared a substantial amount of variance (latent Kappa coefficient =0.66) and identified overlapping subgroups of participants.
In different models of frailty, like the Functional Domains model (the accumulation of deficits), the Burden model (the index of health burden) and the Biologic Syndrome model (frailty as a biological syndrome) multidimensional screening instruments are considered to be most appropriate in screening frailty [ 44].
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Currently, the most frequently adopted model of frailty is the Biological Syndrome developed by Fried et al. (2001), in which frailty is identified based on a specific phenotype.
Unfortunately, although current literature agrees on the bio-psychosocial model of frailty [17], its operational definition is yet unresolved [10, 11, 13, 22].
We aimed to assess the incremental validity of a Comprehensive Model of Frailty (CMF) over Frailty Index (FI) in predicting self-rated health and functional dependency amongst near-centenarians and centenarians.
36 The TFI is based on an integral conceptual model of frailty, including physical, psychological, and social components of frailty and excluding disability.
To date, no model of frailty based on defining and quantifying frailty on a purely data driven approach has been produced.
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