A Review of Frailty Analysis in Older Adults: From Clinical Tools Towards Fully Automated Preventive Systems

Objectives: Frailty is a geriatric syndrome characterized by sarcopenia and physiological impairment. Although the majority of older adults wish to age at home, being frail threatens this choice since it increases the risk of falls and loss of functional independence. Hence, frailty screening and early detection are needed to stop or at least slow down the physical weakening process. In this paper, we present a review in which we discuss the proposed methods from the literature that targets frailty detection and analysis, starting from traditional clinical tools then introducing data-driven studies before highlighting the importance of fully automated systems. Material and methods: We conducted a review study by searching several databases such as Google Scholar, IEEE Xplore, MDPI, and ScienceDirect to name a few. This work presents clinical tools and classical performance tests to assess the health status and the physical function, as well as statistical and observational studies to analyze the frailty syndrome. Moreover, we discuss briefly the work of our research team in this context, represented by the development of a telemonitoring system which aims at the transition from a curative to a preventive model. Results: Firstly, this review points out the absence of a gold standard to detect frailty in older individuals. Secondly, it discusses the limitations of self-reported measures/questionnaires and other traditional performance tests which are based on subjective data and done under supervised conditions. Thirdly, our study emphasizes the lack of robust approaches that target the early detection of frailty and the prediction of a future risk of physical worsening. We propose new research directions based, on the one hand, on automatic activity identification and tracking and, on the other hand, on the analysis of spontaneous speech of elderly. Conclusion: This paper describes research findings and highlights the existing gaps in the context of frailty, and serves as a state of the art for researchers. Additionally, this work suggests future research directions regarding the early detection and prevention of frailty. (c) 2022 AGBM. Published by Elsevier Masson SAS. All rights reserved.