[Frailty in the elderly]

Abstract

Older people differ in their level of multimorbidity, functional dependence and need for assistance. Frailty is a recently constructed syndromatic entity used to characterize vulnerable older people with an increased risk of functional decline, institutionalization and death. This is illustrated by the case history of a 97-year-old woman. In addition to somatic multimorbidity, she suffered from fatigue, weight loss, diminished strength and mood, fear of falling and a decreased gait velocity, without a clear link to a disease. The term 'frailty' is useful in such cases and its application is quickly expanding. Frailty highlights the need to individualize and integrate guidelines for treatment, and to prevent adverse outcomes by choosing health care interventions fit for such frail elderly. However, in practice the frailty syndrome is defined by diverse sets of criteria. As frailty is used to predict different adverse outcomes, a single definition is not possible. Awareness of the advantages and pitfalls of the frailty concept may lead to fruitful clinical application.