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Review
. 2024 Aug 8;391(6):538-548.
doi: 10.1056/NEJMra2301292.

Frailty in Older Adults

Dae Hyun Kim  1 , Kenneth Rockwood  1
Affiliations
Review

Frailty in Older Adults

Dae Hyun Kim et al. N Engl J Med. .
No abstract available

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Figures

Figure 1.
Figure 1.. A Proposed Approach to Clinical Management of Older Patients Based on the Degree of Frailty
Abbreviation: CGA, comprehensive geriatric assessment; FI, frailty index. The proposed approach by the authors combines the evidence from randomized controlled trials and best practices of geriatric care, both of which are necessary to provide evidence-based, person-centered care to older adults across the fit-to-frail spectrum. It should be used as a guide as appropriate based on clinical evaluation. For fit or pre-frail individuals, clinical management should focus on increasing physiologic reserve and managing chronic conditions to prevent long-term negative health effect, including frailty and disability. For individuals with frailty, the management should focus on preserving physiologic reserve and preventing or mitigating stressors. Because these individuals have multimorbidity and polypharmacy, it is often necessary to align treatment to the patient’s personal goals and preferences. As an individual approaches end-stage frailty (i.e., having all 5 features of Fried frailty phenotype, a deficit accumulation frailty index near 0.7, or complete dependence in personal care), the management needs to focus on providing comfort and dignity. The frailty score cutpoints are reasonable estimates, not meant to be used as strict rules. When first applying these cutpoints in clinical practice or research, adjustment to the clinical context may be necessary. Management should be guided by patients’ goals and preferences, and frailty should not be used to prevent access to potentially effective treatments.
See this image and copyright information in PMC

Comment in

  • Frailty in Older Adults.
    Krakauer NY, Krakauer JC. Krakauer NY, et al. N Engl J Med. 2024 Nov 7;391(18):1758. doi: 10.1056/NEJMc2411327. N Engl J Med. 2024. PMID: 39504530 No abstract available.
  • Frailty in Older Adults.
    Zheng Z, Yang S. Zheng Z, et al. N Engl J Med. 2024 Nov 7;391(18):1758. doi: 10.1056/NEJMc2411327. N Engl J Med. 2024. PMID: 39504531 No abstract available.
  • Frailty in Older Adults.
    Canter BE, Evans EA. Canter BE, et al. N Engl J Med. 2024 Nov 7;391(18):1758-1759. doi: 10.1056/NEJMc2411327. N Engl J Med. 2024. PMID: 39504532 No abstract available.
  • Frailty in Older Adults.
    Leff B, Ritchie C, Ornstein KA. Leff B, et al. N Engl J Med. 2024 Nov 7;391(18):1759. doi: 10.1056/NEJMc2411327. N Engl J Med. 2024. PMID: 39504533 No abstract available.
  • Frailty in Older Adults. Reply.
    Kim DH, Rockwood K. Kim DH, et al. N Engl J Med. 2024 Nov 7;391(18):1759-1760. doi: 10.1056/NEJMc2411327. N Engl J Med. 2024. PMID: 39504534 No abstract available.

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