Treating frailty--a practical guide

Abstract

Frailty is a common syndrome that is associated with vulnerability to poor health outcomes. Frail older people have increased risk of morbidity, institutionalization and death, resulting in burden to individuals, their families, health care services and society. Assessment and treatment of the frail individual provide many challenges to clinicians working with older people. Despite frailty being increasingly recognized in the literature, there is a paucity of direct evidence to guide interventions to reduce frailty. In this paper we review methods for identification of frailty in the clinical setting, propose a model for assessment of the frail older person and summarize the current best evidence for treating the frail older person. We provide an evidence-based framework that can be used to guide the diagnosis, assessment and treatment of frail older people.

Figure 1

Important factors to assess in the frail patient and the interactions between them. ^aCaptured in the Frailty Phenotype; ^bDefined as difficulty experienced by an individual when executing activities (International Classification of Functioning (ICF)[26]); ^cDefined as problems experienced by an individual in their involvement in life situations (ICF).