Frailty is a dynamic condition experienced by many older adults. It is a vulnerability to adverse outcomes resulting from an interaction of physical, socio-economic and co-morbidity factors: major adverse events are more common among frail patients in comparison to non-frail patients. (1)
Why is it important?
Prevalence of frailty is higher in women and increases with age
Social vulnerability, aging, and chronic disease lends to development of frail elderly individuals
When an individual is frail the impact of an “illness” further impairs function and ability to cope
Frailty causes increased risk of other diseases
In-hospital mortality is higher among frail patients than among non-frail patients (1)
Frail individuals are more likely to become functionally dependent; have a lower quality of life; and are more often re-admitted to hospital than non-frail individuals
Frailty increases the risk for adverse health outcomes such as falls, hospitalization, increased length of stay, increased costs, with worsening of outcomes including mortality and need for long term placement (1) (3)
Components of the Comprehensive Geriatric Exam can be used to flag issues for further review with Geriatric Periodic Health Exam Focus should be on:
Early identification of onset and acute illness, optimizing sensory inputs, assessing cognition/mood, reviewing medications, and promoting regular exercise and nutrition supplementation.
Optimizing chronic disease management strategies and modify geriatric syndromes (e.g. falls, immobility, confusion, depression, incontinence)
Implementing necessary environmental changes/adaptations and maximization of community and socio-economic supports
Encouraging activity and socialization in order to help prevent advancing frailty
1. Bagshaw, S.M., et al (2014). Association between frailty and short and long-term outcomes among critically ill patients: a multicenter prospective cohort study. CMAJ, 186 (2), doi: 10.1503/cmaj.130639. Retrieved Feb. 2014 from: http://www.cmaj.ca/content/186/2/E95
This 5-Item Geriatric Depression Scale (GDS) screening / assessment tool is used for identifying depression in older adults. Applicable for a wide range of settings and can be used with older adults including those with mild to moderate cognitive impairment. 1 page.
Pre-frailty and frailty is an example of an elder care issue that, when identified and treated, may negatively impact quality metrics for the simple reasons that older adults don’t respond as well to treatment as younger cohorts.
Frailty is a biological syndrome that reflects a state of decreased physiological reserve and vulnerability to stressors. Upward of 20 frailty assessment tools have been developed, with most tools revolving around the core phenotypic domains of frailty—slow walking speed, weakness, inactivity, exhaustion, and shrinking—as measured by physical performance tests and questionnaires.
This short assessment checklist/tool developed for use in primary care assists the clinician to review the client's ongoing medical issues and deliver preventative health care as part of the periodic health exam for the average-risk, male patient. Investigation and immunization sections address the ≥ 65 yr. age group. 2 pages.
The European Society for Clinical Nutrition and Metabolism developed these guidelines with special considerations of older adults. The authors point out that studies have shown an inverse relationship between nutritional status and complication rates, length of stay in hospital, etc. Nutrition should be an integral part of an older adults overall care plan. 6 pages. Last reviewed January 2017.
This reading list provides links to and summaries of a variety of resources related to active aging. Topics covered include physical activity, the role of cognition, social activity/participation, perceptions / models and critical reviews of the concept of active aging and volunteerism. 4 pages. Last reviewed September 2019.