Identifying frailty and its outcomes
Elsa Dent is a researcher at the University of Adelaide specialising in Nutrition and Ageing.
People differ vastly in the way they age. If we are able to predict which individuals are likely to face problems as they age, we may be able to use this information to design preventative programs and to optimise a person’s care and treatment.
One way to identify older people at risk of poor outcomes is by identifying frailty. Frailty is a common condition in older people, although it is not an inevitable part of ageing. It is characterised by weakness, weight loss and a decreased ability to cope with illness and life challenges.
Currently, no international consensus exists as to how to identify frailty. Moreover, the ability of frailty to predict poor outcome is not well established for hospitalised older people.
Our research evaluated the predictive ability of several indices designed to identify frailty and functional decline in older patients at the Queen Elizabeth Hospital in Adelaide, South Australia. We found that these were able to predict patients at risk of poor outcomes, defined as mortality or admission to a residential care facility.
The index which most accurately predicted poor outcome was the ‘Frailty Index of Cumulative Deficits’ which is based on summing a person’s health problems identified during a comprehensive patient assessment.
It must be emphasized that the extent of frailty should not be used to deny older people treatment, rather to offer appropriate medical support and prevent unnecessary harm.