Yes / Rationale and Perceptions of frailty can influence how families cope, quality of life and access to support services. Yet little is known of how lay members of the UK general public perceive frailty. This scoping review aimed to explore how frailty is perceived among the lay public in the United Kingdom. Methods: The established scoping review methodology by Arksey and O’Malley was followed and searches were conducted across eight electronic databases and grey literature websites for articles published between 1990 and August 2022. In total, 6,705 articles were identified, of which six were included in the review. Data were analysed using Braun and Clarke’s thematic analysis framework. Results: Three key themes were identified; frailty as a normal part of ageing, perceived consequences of frailty and coping with frailty. Overall, frailty has negative connotations and is perceived as linked to a natural part of the ageing process, increased dependency, loss of identity and social exclusion and stigma. However, it is unclear whether these perceptions have a direct bearing on access to support services for communities. Conclusion and implications: This review identifies that it is imperative for health and social care service providers to consider the individual meaning of frailty for older people and families, to understand and integrate their particular needs and preferences when planning and delivering person centred frailty care and support. There is also a need for development of interventions that focus on increasing education and reducing stigma around frailty in order to change frailty perceptions in the UK. / This report is independent research funded by the National Institute for Health and Care Research, Yorkshire and Humber Applied Research Collaborations NIHR200166.

Introdução: O comprometimento cognitivo leve (CCL) constitui possivelmente uma fase prodrômica das demências e consequentemente é um alvo importante no diagnóstico precoce e em futuras estratégias terapêuticas. Paralelamente, a síndrome da fragilidade (SF) constitui uma morbidade comum entre idosos e está relacionada com baixo desempenho cognitivo e maior incidência de CCL. Desta forma, espera-se que os idosos com CCL apresentem um maior número de critérios para fragilidade quando comparados aos controles. Objetivo: identificar e caracterizar a SF por meio de instrumentos validados em idosos com CCL. Métodos: desenho transversal, observacional e descritivo. No estudo, 40 idosos com CCL amnéstico e 26 controles sem doenças neuropsiquiátricas, acompanhados em uma coorte de transtornos cognitivos com avaliação de parâmetros clínicos, neurológicos, psiquiátricos, neuropsicológicos e funcionais. A SF foi avaliada através dos critérios de Fried e colaboradores (CHS), da Edmonton Frail Scale (EFS) e da escala FRAIL. Os dados coletados foram analisados através do software R. Resultados: a prevalência da SF variou sobre os critérios utilizados (EFS 7,5%; CHS 30%) e foi significativamente maior no grupo CCL quando avaliada pela EFS (p = 0,047), mas não com o de CHS (p = 0,255) ou FRAIL (p = 0,155). A variável fadiga em CHS (p = 0,036) e as variáveis humor (p = 0,019) e independência funcional (p = 0,042) da EFS foram significativamente diferentes entre os grupos. A função visuo-espacial (OR = 2,405, p = 0,042) foi associada aos critérios CHS. Observou-se correlação significativa entre o parâmetro peso do CHS com independência funcional (p = 0,034), nutrição (p = 0,002) e continência (p = 0,035) da EFS; entre marcha do CHS com independência funcional (p = 0,001), medicamento (p = 0,015) e desempenho funcional (p < 0,001) da EFS; e entre fadiga do CHS com estado geral de saúde (p = 0,032), medicamento (p = 0,038) e desempenho funcional (p = 0,016) da EFS. Conclusão: a identificação de características de fragilidade em CCL depende do protocolo utilizado para avaliação. A função visuo-espacial esteve relacionada com maior risco para fragilidade segundo o CHS / Introduction: Mild cognitive impairment (MCI) is a possibly prodromal phase of dementia and therefore is an important target in the early diagnosis and future treatment strategy. At the same time, the fragility syndrome (FS) is a common disease among the elderly and is associated with low cognitive performance and higher incidence of MCI. Thus, it is expected that the elderly with MCI show a greater number of criteria for frailty when compared to controls. Objective: To identify and characterize the FS through validated instruments in elderly patients with MCI and evaluate cognitive performance according to the frailty phenotype. Methods: cross-sectional, observational and descriptive design. In the study, 40 subjects with amnestic MCI and 26 controls without neuropsychiatric disorders, follow-up in a cohort of cognitive disorders with clinical, neurological, psychiatric, neuropsychological and functional evaluation. The FS was assessed by the Fried criteria (CHS), the Edmonton Frail Scale (EFS), and the FRAIL scale. Data were analyzed using the software R. Results: the prevalence of SF varied on the criteria used (EFS 7.5%, CHS 30%) and was significantly higher in the MCI group when assessed by EFS (p = 0.047), but not with the CHS (p = 0.255) or FRAIL (p = 0.155). The variable fatigue of CHS (p = 0.036) and variables mood (p = 0.019) and functional independence (p = 0.042) from EFS were significantly different among groups. The visuospatial function (OR = 2.405, p = 0.042) was associated with CHS criteria. There was a significant correlation between the CHS weight parameter with functional independence (p = 0.034), nutrition (p = 0.002) and continence (p = 0.035) of EFS; between gait in CHS with functional independence (p = 0.001), medicine (p = 0,015) and functional performance (p < 0.001) of EFS; and between fatigue from CHS with general health (p = 0.032), medication (p = 0.038) and functional performance (p = 0.016) of EFS. Conclusion: The identification of frailty features in MCI depends on the protocol used for evaluation. The visuospatial function was related to higher risk of frailty according to CHS

Thesis (M.G.S.)--Miami University, Dept. of Sociology and Gerontology, 2007. / Title from first page of PDF document. Includes bibliographical references (p. 48-50).

Introdução: O comprometimento cognitivo leve (CCL) constitui possivelmente uma fase prodrômica das demências e consequentemente é um alvo importante no diagnóstico precoce e em futuras estratégias terapêuticas. Paralelamente, a síndrome da fragilidade (SF) constitui uma morbidade comum entre idosos e está relacionada com baixo desempenho cognitivo e maior incidência de CCL. Desta forma, espera-se que os idosos com CCL apresentem um maior número de critérios para fragilidade quando comparados aos controles. Objetivo: identificar e caracterizar a SF por meio de instrumentos validados em idosos com CCL. Métodos: desenho transversal, observacional e descritivo. No estudo, 40 idosos com CCL amnéstico e 26 controles sem doenças neuropsiquiátricas, acompanhados em uma coorte de transtornos cognitivos com avaliação de parâmetros clínicos, neurológicos, psiquiátricos, neuropsicológicos e funcionais. A SF foi avaliada através dos critérios de Fried e colaboradores (CHS), da Edmonton Frail Scale (EFS) e da escala FRAIL. Os dados coletados foram analisados através do software R. Resultados: a prevalência da SF variou sobre os critérios utilizados (EFS 7,5%; CHS 30%) e foi significativamente maior no grupo CCL quando avaliada pela EFS (p = 0,047), mas não com o de CHS (p = 0,255) ou FRAIL (p = 0,155). A variável fadiga em CHS (p = 0,036) e as variáveis humor (p = 0,019) e independência funcional (p = 0,042) da EFS foram significativamente diferentes entre os grupos. A função visuo-espacial (OR = 2,405, p = 0,042) foi associada aos critérios CHS. Observou-se correlação significativa entre o parâmetro peso do CHS com independência funcional (p = 0,034), nutrição (p = 0,002) e continência (p = 0,035) da EFS; entre marcha do CHS com independência funcional (p = 0,001), medicamento (p = 0,015) e desempenho funcional (p < 0,001) da EFS; e entre fadiga do CHS com estado geral de saúde (p = 0,032), medicamento (p = 0,038) e desempenho funcional (p = 0,016) da EFS. Conclusão: a identificação de características de fragilidade em CCL depende do protocolo utilizado para avaliação. A função visuo-espacial esteve relacionada com maior risco para fragilidade segundo o CHS / Introduction: Mild cognitive impairment (MCI) is a possibly prodromal phase of dementia and therefore is an important target in the early diagnosis and future treatment strategy. At the same time, the fragility syndrome (FS) is a common disease among the elderly and is associated with low cognitive performance and higher incidence of MCI. Thus, it is expected that the elderly with MCI show a greater number of criteria for frailty when compared to controls. Objective: To identify and characterize the FS through validated instruments in elderly patients with MCI and evaluate cognitive performance according to the frailty phenotype. Methods: cross-sectional, observational and descriptive design. In the study, 40 subjects with amnestic MCI and 26 controls without neuropsychiatric disorders, follow-up in a cohort of cognitive disorders with clinical, neurological, psychiatric, neuropsychological and functional evaluation. The FS was assessed by the Fried criteria (CHS), the Edmonton Frail Scale (EFS), and the FRAIL scale. Data were analyzed using the software R. Results: the prevalence of SF varied on the criteria used (EFS 7.5%, CHS 30%) and was significantly higher in the MCI group when assessed by EFS (p = 0.047), but not with the CHS (p = 0.255) or FRAIL (p = 0.155). The variable fatigue of CHS (p = 0.036) and variables mood (p = 0.019) and functional independence (p = 0.042) from EFS were significantly different among groups. The visuospatial function (OR = 2.405, p = 0.042) was associated with CHS criteria. There was a significant correlation between the CHS weight parameter with functional independence (p = 0.034), nutrition (p = 0.002) and continence (p = 0.035) of EFS; between gait in CHS with functional independence (p = 0.001), medicine (p = 0,015) and functional performance (p < 0.001) of EFS; and between fatigue from CHS with general health (p = 0.032), medication (p = 0.038) and functional performance (p = 0.016) of EFS. Conclusion: The identification of frailty features in MCI depends on the protocol used for evaluation. The visuospatial function was related to higher risk of frailty according to CHS

Background: By the year 2030 the prognosis is that one fourth of the Swedish population will be 65 years or older. An age group that today stands for 40 percent of all the daily visits in the Swedish emergency departments. Nearly half of them are 80 years or older. The frail older adults are often low prioritized due to their diffuse symptoms whereby long waiting times and healthcare-related injuries may occur. As a complement to the standard prioritizing procedure, that triage stands for, some emergency departments have introduced screening tools for detecting those individuals that are older adults and frail. Unfortunately, the introduction of new guidelines, do not always imply that the implementation comes easy because there are factors that facilitate and inhibit their intended use. Aim: To illustrate factors that affect the nurses use of the screening tool Clinical Frailty Scale (CFS) which identifies frailty in elders during triage in the emergency department. Method: A descriptive quantitative cross-sectional study where data was collected through a web-based questionnaire. The data of the study was analyzed through descriptive and analytical statistics. Results: When it came to influencing factors regarding the use of CFS in the selected emergency department, CFS as a method with its practicalities constituted as facilitators, whilst the organizational and working cultural aspects constituted as barriers. The differences in the nurses' experience and education effected the perception of CFS in different ways. Conclusion: There is a need of a working culture where responsibility is shared between stakeholders to facilitate a guideline. Advanced nurse practitioners can have a crucial role in educating, motivating and creating space for discussion relating to organizational, theoretical and practical components of the process in identifying the frail older adults. / Bakgrund: Prognosen är att år 2030 kommer en fjärdedel av den svenska populationen vara 65 år eller äldre. Åldersgruppen utgör idag cirka 40 procent av alla besök på Sveriges akutmottagningar där nästan hälften av dem är 80 år eller äldre. De sköra äldre erhåller ofta låg prioritering på grund av sina diffusa symtom, där långa väntetider och vårdrelaterade skador kan uppstå som följd. Som komplement i den vanliga prioriteringsrutinen som triagering innebär har akutmottagningar infört screeningverktyg för att upptäcka de individer som är sköra äldre. Dessvärre innebär införandet av nya rutiner att de inte alltid lätt implementeras i verksamheten eftersom det finns faktorer som främjar och hindrar dess avsedda användning. Syfte: Att belysa faktorer som påverkar sjuksköterskors användning av screeningverktyget Clinical Frailty Scale (CFS) för att identifiera sköra äldre vid triagering på akutmottagningen. Metod: En kvantitativ tvärsnittsstudie där data samlades in genom en webbenkät. Studiens data analyserades deskriptivt samt med analytisk statistisk. Resultat: När det kom till faktorer som påverkade användningen av CFS på den valda akutmottagningen utgjorde CFS som metod med dess praktiska delar en främjande faktor, medan organisatoriska och arbetskulturella aspekter utgjorde hindrande faktorer. Skillnaderna i erfarenhet och utbildning hos sjuksköterskorna påverkade uppfattningen om CFS på olika sätt. Slutsats: Det behövs en arbetskultur med ett delat ansvar mellan organisation och medarbetare för att främja följsamheten till en rutin. Specialistsjuksköterskor kan ha en betydande roll i att utbilda, motivera och skapa forum för diskussion gällande organisatoriska, teoretiska och praktiska delar i processen av att identifiera sköra äldre.

Background: Physically injured elder adults present challenges in the emergent injury phase. Oxidative stress contributes to cellular deterioration, resulting in decreases in physiological reserve. Imbalance of oxidative stress pathways lead to damage and drive the aging process and frailty. Goals of this study were to determine if a new plasma biomarker of oxidative stress is related to: 1) oxidation reduction status in patients who have experienced traumatic injury as well as healthy community dwellers, 2) outcomes of patients who have experienced trauma, 3) frailty measured by established frailty scales in healthy community dwellers. Methods: Prospective study included 1) trauma patients ≥65 admitted to Level I trauma center 2) age, gender matched healthy, community-dwelling participants. Plasma samples tested in duplicate for capacity oxidative reductive potential (cORP, μC; antioxidant reserve), and static oxidative reductive potential (sORP, mV; the current state of oxidative stress). Frailty assessments were performed in healthy participants using established frailty scales. ORP measurements were analyzed using correlation analyses. Univariate analysis analyzed cORP and sORP for differences by the variables gender, age, smoking, diabetes, statin use, vitamin use and any alcohol use in both the injured and healthy populations. Results: 186 subjects included in study (N=93 for both groups). Trauma groups's cORP values were significantly lower in patients with diabetes (p<0.05) and patients that smoked (p<0.01). Similarly the healthy group's cORP was significantly lower for those who smoked and those with diabetes (p<0.05). Non-vitamin use in the healthy group was related to lower cORP values (p<0.05). Trauma patients who smoked and those with diabetes exhibited higher sORP values (p<0.05). In the healthy group, sORP did not differ when considering the variables. No12significant differences were found based on gender, statin or alcohol use for either group. Significant correlation was found for both sORP and cORP with CSHA Clinical Frailty Scale in the healthy group. Conclusion: Findings suggest that the variables of smoking and diabetes are contributory to frailty trajectory. Data suggest the capacity to tolerate oxidative stress, measured by cORP, is lower in aged individuals that smoke or are diabetic and contributes to frailty as a result of oxidative damage.

Background: Frailty, a state indicating vulnerability to poor health outcomes, is a common condition in later life. However, research and intervention progress is hindered by the current lack of a consensus frailty definition and poor understanding of relationships between frailty and depression. Objectives: The goal of this research is to understand the interrelationships between frailty and depression among older adults. Specifically, this project aims 1) to examine the construct overlap between depression and three definitions of frailty (biological syndrome, medical burdens, and functional domains), 2) to determine the degree to which this overlap varies by age, gender, race/ethnicity and other individual characteristics, 3) to evaluate how the association between frailty and depression influences prediction of adverse health outcomes. Methods: This project uses data from the 2004-2012 Health and Retirement Study (HRS), an ongoing, nationally-representative cohort study of adults over the age of 55. Frailty was indexed by three alternative conceptual models: 1) biological syndrome, 2) cumulative medical burdens, and 3) functional domains. Depressive symptoms were indexed by the 8-item Center for Epidemiologic Studies Depression (CESD) scale. Latent class analysis and confirmatory factor analysis were used to assess the construct overlap between depressive symptoms and frailty. Latent growth curve modeling were used to evaluate associations between frailty and depression, and to estimate their joint influence on two adverse health outcomes: nursing home admission and falls. Results: The measurement overlap of frailty and depression was high using a categorical latent variable approach. Approximately 73% of individuals with severe depressive symptoms, and 85% of individuals with primarily somatic depressive symptoms, were categorized as concurrently frail. When modeled as continuous latent factors, each of the three frailty latent factors was significantly correlated with depression: biological syndrome (ρ = .67, p <.01); functional domains (ρ = .70, p <.01); and medical burdens (ρ = .62, p <.01). Higher latent frailty trajectories were associated with higher likelihood of experiencing nursing home admission and serious falls. This association with adverse health outcomes was attenuated after adjustment for depression as a time-varying covariate. Conclusions: Findings suggest that frailty and frailty trajectories are potentially important indicators of vulnerability to adverse health outcomes. Future investigations of frailty syndrome, however it is operationalized, should account for its substantial association with depression in order to develop more accurate measurement and effective treatment.

Abstract Background: Frailty is a physiological condition caused by aging which increases the risk for adverse health problems and extended need for health and social care. This condition can be prevented, and to some extent treated, with physical activity. But research shows that older adults spend as much as 62 to 86 percent of their waking time sedentary. However, there is a lack of research, national studies in particular, looking into what specifically motivates older adults to physical activity. Purpose:The purpose of this study was to gain a better understanding of which aspects, and why, that motivated physically inactive older adults to become physically active.  Method: The study was conducted with a qualitative study design in the form of four focus groups interviews. The 19 respondents consisted of older adults with a physical inactive lifestyle. The Health Belief Model was used as a theoretical framework. A thematic content analysis with a deductive approach was used when processing collected data. Result: 16 subcategories were found answering the research questions and four of these were more prominent than the others: Companionship and social health, Possibilities to choose, Physical Activity on Prescription (FaR®) and No fear and worries. The theme Barriers stood out compared to the others themes since containing a larger number of subcategories. Conclusion: There were aspects within both health and social care as on a societal- and personal level that motivated the respondents to an increased physical activity. Further research is however needed within this area. Not only looking into what motivates older adults to an active lifestyle in general, but also what especially motivates those who are at greatest risk for frailty or already being frail. / Sammanfattning Bakgrund: Skörhet (frailty) är ett åldersrelaterat fysiologiskt tillstånd som ökar risken för allvarliga hälsoproblem och ett ökat behov av hälso- och sjukvård. Detta tillstånd kan förebyggas, och i viss mån behandlas, med fysisk aktivitet. Forskning visar dock att äldre vuxna spenderar så mycket som 62 till 86 procent av sin vakna tid stillasittande. Men det saknas forskning, speciellt nationella studier, på vad som specifikt motiverar äldre vuxna till fysisk aktivitet. Syfte: Den här studiens syfte var att öka förståelsen för vilka aspekter, och varför, som kunde motivera fysiskt inaktiva äldre vuxna till att bli fysisk aktiva. Metod: Studien genomfördes med en kvalitativ forskningsdesign i form utav fyra stycken fokusgruppsintervjuer. De 19 respondenterna bestod av äldre vuxna med en fysiskt inaktiv livsstil. The Health Belief Model utgjorde studiens teoretiska referensram. En tematisk innehållsanalys med en deduktiv ansats användes när det insamlade datat processades. Resultat: 16 subkategorier hittades som svarade på forskningsfrågorna och fyra av dessa var mer framträdande än de andra: Kamratskap och social hälsa, Valmöjligheter, Fysisk Aktivitet på Recept (FaR®) och Ingen rädsla eller oro. Temat Hinder stod ut jämfört med övriga teman då det innehöll ett större antal subkategorier. Slutsats: Det fanns aspekter inom både hälso- och sjukvård samt på samhälls- och individnivå som påverkade deltagarnas motivation till en ökad fysisk aktivitet. Ytterligare forskning behövs dock inom det här området. Inte enbart på vad som generellt motiverar äldre vuxna till en aktiv livsstil, utan också vad som specifikt motiverar de individer som är i störst risk för skörhet eller redan är sköra.

Frequentemente eventos intermediários fornecem informações mais detalhadas sobre o processo da doença ou recuperação, por exemplo, e permitem uma maior precisão na previsão do prognóstico de pacientes. Tais eventos não fatais durante o curso da doença podem ser vistos como transições de um estado para outro. A ideia básica dos modelos multiestado é que o indivíduo se move através de uma serie de estados em tempo contínuo, sendo possível estimar as probabilidades e intensidades de transição entre eles e o efeito das covariáveis associadas a cada transição. Muitos estudos incluem o agrupamento dos tempos de sobrevivência como, por exemplo, em estudos multicêntricos, e também é de interesse estudar a evolução dos pacientes ao longo do tempo, caracterizando assim dados multiestado agrupados. Devido ao fato de os dados virem de diferentes centros/grupos, os tempos de falha desses indivíduos estarem agrupados e a fatores de risco comuns não observados, é interessante considerar o uso de fragilidades para que possamos capturar a heterogeneidade entre os grupos no risco para os diferentes tipos de transição, além de considerar a estrutura de dependência entre transições dos indivíduos de um mesmo grupo. Neste trabalho apresentamos a metodologia dos modelos multiestado, dos modelos de fragilidade e, em seguida, a integração dos modelos multiestado com modelos de fragilidade, tratando do seu processo de estimação paramétrica e semiparamétrica. O estudo de simulação realizado mostrou a importância de considerarmos fragilidade sem modelos multiestado agrupados, pois sem considerá-las, as estimativas tornam-se viesadas. Além disso, verificamos as propriedades frequentistas dos estimadores do modelo multiestado com fragilidades aninhadas. Por fim, como um exemplo de aplicação a um conjunto de dados reais, utilizamos o processo de recuperação de transplante de medula óssea de pacientes tratados em quatro hospitais. Fizemos uma comparação de modelos por meio das medidas de qualidade do ajuste AIC e BIC, chegando à conclusão de que o modelo que considera dois efeitos aleatórios (uma para o hospital e outro para a interação transição-hospital) ajusta-se melhor aos dados. Além de considerar a heterogeneidade entre os hospitais, tal modelo também considera a heterogeneidade entre os hospitais em cada transição. Sendo assim, os valores das fragilidades estimadas da interação transição-hospital revelam o quão frágeis os pacientes de cada hospital são para experimentarem determinado tipo de evento/transição. / Often intermediate events provide more detailed information about the disease process or recovery, for example, and allow greater accuracy in predicting the prognosis of patients. Such non-fatal events during the course of the disease can be seen as transitions from one state to another. The basic idea of a multistate models is that the person moves through a series of states in continuous time, it is possible to estimate the transition probabilities and intensities between them and the effect of covariates associated with each transition. Many studies include the grouping of survival times, for example, in multi-center studies, and is also of interest to study the evolution of patients over time,characterizing grouped multistate data. Because the data coming from different centers/groups, the failure times these individuals are grouped and the common risk factors not observed, it is interesting to consider the use of frailty so that we can capture the heterogeneity between the groups at risk for different types of transition, in addition to considering the dependence structure between transitions of individuals of the same group. In this work we present the methodology of multistate models, frailty models and then the integration of models with multi-state fragility models, dealing with the process of parametric and semi-parametric estimation. The conducted simulation study showed the importance of considering frailty in grouped multistate models, because without conside- ring them, the estimates become biased. Furthermore, we find the frequentist properties of estimators of multistate model with nested frailty. Finally, as an application example to a set of real data, we use the process of bone marrow transplantation recovery of patients in four hospitals. We did a comparison of models through quality measures setting AIC and BIC, coming to the conclusion that the model considers two random effects (one for the hospital and another for interaction transition-hospital) fits the data better. In addition to considering the heterogeneity between hospitals, such a model also considers the heterogeneity between hospitals in each transition. Thus,the values of the frailty estimated interaction transition-hospital reveal how fragile patients from each hospital are to experience certain type of event/transition.

Introduction : Grâce aux progrès des traitements et au diagnostic précoce, les cancers sont de mieux en mieux pris en charge et guéris. Toutefois durant la maladie et ses traitements, les patients ressentent souvent de la fatigue et celle-ci peut avoir un impact sur l'évolution de la maladie et la survie. La prévalence des cancers est d'autant plus élevée que la personne est âgée, personnes qui sont davantage touchées par la fatigue. Cette fatigue est accentuée par la fragilité des patients qui se caractérise par une faiblesse, une lenteur de marche ou encore une perte de poids involontaire. Des facteurs médicaux et psycho-sociaux sont associés à la fatigue et il est important de les évaluer pour mieux les prendre en compte lors de la prise en charge des patients. L'objectif de ce travail de thèse est d'étudier le rôle de certains facteurs psycho-sociaux (coping, soutien social, dépression et routinisation) associés à la fatigue chez des patients âgés et fragiles atteints d'un lymphome non-Hodgkinien.Méthode : Cette recherche, intitulée Psyfrail, est une étude ancillaire à un essai randomisé nommé Frail. Les patients inclus (n=50), âgés en moyenne de 82 ans, ont été évalués au niveau de la fatigue, de la dépression, du coping, du soutien social et de la routinisation lors d'un rendez-vous avec un psychologue avant le début des traitements (T1), au milieu (T2) et à la fin (T3). Des analyses transversales et longitudinales ont été effectuées pour mettre en évidence les facteurs associés à la fatigue aux différents temps de mesure et à son évolution.Résultats : L'utilisation de stratégies de coping centrées sur le problème à T1 est associée à une diminution des scores de fatigue générale et de réduction des activités à T1 et une diminution de la réduction de la motivation à T2. La routinisation augmente les scores de fatigue mentale et de réduction de la motivation à T2. La disponibilité du soutien social permet une moindre augmentation du score de réduction de la motivation au cours du temps. La diminution de la fatigue générale est moindre chez les patients ayant des niveaux élevés de coping centré sur l'émotion. La dépression est associée à une fatigue plus importante à T1 et T2.Conclusion : La promotion de stratégies adaptées pour aider les patients à faire face à la maladie et la prise en charge de la dépression pourrait avoir un impact positif sur la réduction de la fatigue. / Introduction: Thanks to the progress of treatments and early diagnosis, cancers are better cured. However, during the disease and its treatments, patients often experience fatigue which could have an impact on disease progression and survival. Medical and psycho-social factors are associated with fatigue, which makes them important to evaluate in order to consider them properly when taking care of patients. Cancer prevalence is higher in the elderly, who are more affected by fatigue. This fatigue increases with frailty, characterized by a state of weakness, slow walking speed or unintentional weight loss. This is why we chose to focus on this specific populationThe objective of this thesis is to study the role of several psychosocial factors (coping, social support, depression and routinization) associated with fatigue in frail elderly patients with non-Hodgkin lymphoma.Method: This research, entitled Psyfrail, is an ancillary study to a randomized trial named Frail. The 50 patients included, with a mean age of 82 years old, were evaluated in terms of fatigue, depression, coping, social support and routinization during a meeting with a psychologist before the start of treatment (T1), in the middle (T2) and at the end (T3). Cross-sectional and longitudinal analyzes were conducted to highlight the factors associated with fatigue at different measurement times and with its evolution.Results: The use of problem-focused coping at T1 is associated with a decrease in general fatigue and reduced activity scores at T1 and a decrease in the reduced motivation score at T2. Routinization increases mental fatigue and reduced motivation scores at T2. Social support availability is associated with a smaller increase in the reduced motivation score over time. The decrease in general fatigue is reduced in patients with high level of emotion focused coping. Depression is associated with a higher fatigue at T1 and T2.Conclusion: The promotion of appropriate strategies to help patients cope with the disease and the treatment of depression could have a positive impact on reducing fatigue.