Home and Clinical Assessments of Instrumental Activities of Daily Living: What could Explain the Difference Between Settings in Frail Older Adults, If Any?(Critical Review) (Report‪)‬

Introduction In Europe, people aged 65 years and over make up nearly 17% of the population and this percentage is expected to increase in the coming years (European Commission 2007). Ageing is accompanied by an increased risk of frailty, defined as vulnerability due to a reduction in physiological reserves and resistance to stressors (Fried et al 2001, Rockwood et al 2005). More specifically, frailty has been found to lead to decreased physical capacities (Fried et al 2001) and sometimes a sensory and /or cognitive decline (Strawbridge et al 1998, Puts et al 2005). Some studies also show an association between frailty and some psychological characteristics, such as anxious and depressive symptoms (Tinetti et al 1995, Studenski et al 2004). Others report that frailty is correlated with some sociodemographic characteristics, such as older age and less schooling (Beland et al 1998, Fried et al 2001). These characteristics are often accompanied by comorbidities (such as vascular, cardiac, renal, pulmonary and osteoarticular problems) and functional decline, which increase the health care needs of frail older adults (Fried et al 2004). Hence, frail older adults make up a large percentage of patients seen in hospitals (Gravelle et al 2007).