Frailty is a state of vulnerability associated with increased risks of fall, hospitalization, cognitive deficits, and psychological distress. Studies with healthy seniors suggest that physical exercise can help improve cognition and quality of life. The results of this study showed that the benefits of exercise training, 3 times per week for a 12 week period were equivalent between frail and non-frail participants.

This blog is created and maintained by a group of Canadian researchers and clinicians brought together by an interdisciplinary fellowship training program with the Canadian Frailty Network. The aim of the blog is to provide helpful information and highlight resources.

As Canada’s population ages, frailty – with its increased risk of functional decline, deterioration in health status, and death – will become increasingly common. The physiology of frailty reflects its multisystem, multi-organ origins. About a quarter of Canadians over age 65 are frail, increasing to over half in those older than 85. Our health care system is organized around single-organ systems, impairing our ability to effectively treat people having multiple disorders and functional limitations. To address frailty, we must recognize when it occurs, increase awareness of its signifi cance, develop holistic models of care, and generate better evidence for its treatment. Recognizing how frailty impacts lifespan will allow for integration of care goals into treatment options. Different settings in the Canadian health care system will require different strategies and tools to assess frailty. Given the magnitude of challenges frailty poses for the health care system as currently organized, policy changes will be essential.  17 pages.  Last reviewed January 2017.

The authors explore the role of the informal caregiver (often a family member) who is often at odds with how clinicians and teams approach "patient-centered care".  They argue that as the prevalence of frailty continues to increase, we need to embrace new approaches that widen the circle of care to include the caregiver more prominenty in the provision of information and a more nuanced approach to shared decision-making.  3 pages.  Last reviewed January 2017.

The authors present a case-based approach to applying exercise and physical activity recommendations for individuals at high risk of falls and fractures.  They summarize Too Fit to Fracture "clinical pearls" for geriatric practice, including advice on assessment, exercise, safe physical activity, and pain management.  Best evidence supports the recommendation that older adults should engage in a multicomponent exercise program, including resistance training and challenging balance exercises, in addition to aerobic physical activity.  The Too Fit to Fracture recommendations support daily attention to posture, and exercises to improve back extensor strength.  16 pages.  Last reviewed January 2017.

This research paper commissioned by the Law Commission of Ontario describes the work in gathering evidence regarding the needs and wishes of patients, caregivers and stakeholders about care at the end of life in their own words.  111 pages.  Last reviewed January 4, 2017.

This recording of a presentation by researcher Olga Theou, of Dalhousie University was about a review to identify and document the nature and extent of research evidence, policies and practice related to measuring frailty in pre-hospital and in-hospital settings.

Laurie Mallery, Constance LeBlanc and Michael Allen of Dalhousie University presented this webinar on Wednesday, February 1, 2017 and discussed their knowledge synthesis of the available evidence and clinical expert opinion to develop practice guidelines for prescribers and a decision aid to facilitate discussion about appropriate antidepressant use for LTC home residents with advanced frailty and/or dementia. 

Jacques Lee of the Sunnybrook Research Institute presented this webinar on Wed, Jan 25, 2017 about the FOCUS study tested the real-world implementation of a user-friendly tablet based technology to identify high-risk older adults with frailty or problems with their thinking such as delirium or dementia. 

The objectives of this presentation are to provide an overview of a framework for looking at Advance Care Planning (ACP) and Goals of Care (GOC) discussions; to look at the current evidence for the effectiveness of ACP and to appreciate the challenges involved in performing and studying ACP with frail patients.