Module 2: Direct Comprehensive Primary Care in the LTC Setting
43 2.5.1 Frailty
Frailty as a Syndrome
•Frailty is a complex clinical syndrome with multiple causes and contributors characterized by:
•Diminished strength
•Decreased endurance
•Reduced physiologic function
•Increases an individual’s vulnerability for developing increased dependency and/or death
•Discrete from disease and disability
•Often chronic and progressive but can be dynamic and potentially reversible
Frailty = Increased vulnerability + stressor –> adverse event[1][2][3][4]
Frailty Screening Tools:
Frail NH – Simplifies Frailty Screening Screens Residents at Bedside
Frailty Index – Predicts outcomes in communities
Edmonton Frail Scale – Valid, multidimensional reliable index to measure alterations related to frailty
Clinical Frailty Scale – Clinical use, judgement based tool to screen for frailty and degrees of fitness and frailty
Functional Assessment Staging Tool (FAST Scale) – Functional assessment especially in residents with dementia.
Gerontopole Frailty Screening Tool (GFST) – Scale that directly focuses on signs and symptoms of frailty
Management of Frailty:
- No recommendations to screen for frailty
- Identifying frailty at an earlier stage can be challenging and is best complemented with the use of valid, reliable tools
- Multicomponent interventions should be based on
- Allison et al., 2021 ↵
- Canadian Frailty Network, 2018 ↵
- CGA Toolkit, n.d.-a ↵
- Fried et al., 2001 ↵
- Van Kan et al., 2008 ↵
- Cowles, n.d ↵
- Rolfon et al., 2006 ↵
- Rockwood et al., 2005 ↵
- Sukkriana & Punsawad, 2020 ↵
- CDC, 2017 ↵
- Geriatric Medicine Research, n.d. ↵
- Clegg et al., 2013 ↵
- Abbasi et al., 2018 ↵
- Meneilly et al., 2018 ↵