Frailty Definitions In Chinese Literature: A Systematic Review To Inform Age-Friendly Healthcare

Abstract Background Frailty, translated into Chinese as “衰弱”, combining “衰” (decline) and “弱” (weakness), is increasingly recognised as a key factor in designing sustainable, age-friendly healthcare systems. In China, frailty research began relatively late. Western standards often lack applicability among Chinese older adults, particularly those with differing health beliefs. The influence of Traditional Chinese Medicine also introduces culturally specific understandings that may obscure or conflict with standard definitions. Without clear, localised frameworks, frailty identification, assessment and care risk being delayed or fragmented. This makes the development of culturally appropriate definitions urgent for both policy and clinical practice. The lack of shared understanding between policy-makers and practitioners further complicates early identification and service integration. Methods A systematic review is underway, examining Chinese biomedical literature from 2014 to 2024. Articles are retrieved using the term “衰弱” from databases such as Chinese Medical Journal, SinoMed, and others. Definitions are categorised by source (original/adapted), conceptual aspect (biological, psychological, sociological), and features including stress, vulnerability, dynamicity, reversibility, and geriatric syndromes. Results Most studies cite existing definitions rather than propose new ones. Following the Chinese Geriatrics Society’s official definition, more articles have adopted its content as a standard reference. Stress and vulnerability frequently co-occur with geriatric syndromes, while dynamicity and reversibility are less commonly mentioned. Although awareness of frailty’s modifiable nature is increasing, psychological and social dimensions remain underrepresented. Some authors still rely solely on Western frameworks, resulting in a fragmented conceptual landscape. Conclusion Findings highlight the need for consistent and culturally adapted frailty definitions to support age-friendly clinical assessment and service design in China. By clarifying key features and gaps, this review lays a foundation for further research and contributes to developing healthcare models that are both sustainable and culturally sensitive. Aligning frailty definitions with local beliefs and clinical realities will support more equitable and age-inclusive service delivery.