Table 2.

Future research directions to define the interrelationship of frailty and delirium

Research Area	Questions for Future Research
Risk Factors	Is frailty is an independent risk factor for delirium?
	Determine the role/impact/effect of cognitive functioning in frailty.
	How does comorbidity, both medical and neurological, interact with frailty and delirium?
Pathophysiology	What are the common pathophysiological mechanisms of frailty and delirium?
	Are there genetic predispositions?
	Do frailty and delirium share biomarkers (e.g. cytokines)?
Recovery from Stressor	Does delayed or incomplete recovery from a stressor signify pre-stressor frailty?
	Does delirium trigger a transition from a pre-frail state to frailty?
	Can delirium be used as a model for a stressor to examine the subsequent frailty course?
Long-term Outcomes	Is there anything unique about delirium as a “precipitant” of frailty that would modify the known relationship between frailty and adverse functional outcomes?
	Does delirium cause long-term cognitive and functional decline?
	Does recovery from frailty describe a resilience that protects against negative long-term outcomes?
Prevention	Does preventing delirium prevent subsequent frailty?
	Does prevention or treatment of frailty reduce delirium risk?
Treatments	Are there common prevention or treatment interventions that can be used for frailty and delirium?
	Will multidisciplinary programs impact on the course of frailty or delirium?
System	Are there systemic measures that can capture delirium and frailty in existing records to define the scope of the problem?
	Will incentives to prevent delirium have an impact on subsequent frailty?
	What are the cost implications of superimposed delirium and frailty to the patient, institution, physician, system, and society?