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)
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)
Align goals and preferences of the patient and family
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
Consult physiotherapist, occupational therapist, recreationist as feasible
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