3196 Proxy indicators to support independent ageing-in-place in older people with frailty: a Delphi-style expert consultation survey

Abstract Introduction In the context of frailty, there is a call to reframe the goal from ‘managing the condition’ to ‘living well with the condition’. Older people with or at risk of frailty who live at home can still lead fulfilling lives, engage with their community, and maintain a good quality of life, that is, age in place well. We need reliable and valid measures capturing the various ageing-in-place experiences of older people with frailty in the community to support them better. This expert consultation survey aimed to identify potential ageing-in-place indicators for community-dwelling older people with frailty. Methods We used a modified Delphi approach to build consensus on ageing-in-place indicators for older people with frailty using two survey rounds. Eighty-nine indicators were extracted from a rapid literature review and grouped into five themes: ‘Personal Characteristics of Older People,’ ‘Place,’ ‘Social Networks,’ ‘Support,’ and ‘Technology.’ Twenty experts rated indicators on a 1–5 scale for importance for ageing-in-place and feasibility of routine measurement. Consensus was defined as mean importance and feasibility ratings of ≥4.0, suggesting indicators were extremely or very important and feasible to routinely measure. Results Only four indicators met the criteria for consensus: physical performance and mobility, multimorbidity, sensory function, and pressure ulcers (all ‘Personal Characteristics’). Thirty indicators were rated extremely or very important for ageing-in-place (20 related to ‘Personal Characteristics’, four to ‘Social Networks’, and three to ‘Place’ and ‘Support’ each). Only five indicators were considered extremely or very feasible to routinely measure: multimorbidity, pressure ulcers, physical performance and mobility, polypharmacy, and sensory function. Conclusions Future directions include: (1) using these indicators to stratify risk in older people with frailty to implement targeted policies and personalised interventions; (2) understanding challenges in routinely assessing non-clinical indicators; and (3) understanding where in care pathways these indicators can be feasibly measured.