{"id":1096,"date":"2024-05-11T15:00:59","date_gmt":"2024-05-11T19:00:59","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/?post_type=chapter&#038;p=1096"},"modified":"2024-05-11T15:00:59","modified_gmt":"2024-05-11T19:00:59","slug":"2-5-1-frailty","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/chapter\/2-5-1-frailty\/","title":{"raw":"2.5.1 Frailty","rendered":"2.5.1 Frailty"},"content":{"raw":"Frailty as a Syndrome\r\n<div>\u2022Frailty is a complex clinical syndrome with multiple causes and contributors characterized by:<\/div>\r\n<div>\u2022Diminished strength<\/div>\r\n<div>\u2022Decreased endurance<\/div>\r\n<div>\u2022Reduced physiologic function<\/div>\r\n<div>\u2022Increases an individual's vulnerability for developing increased dependency and\/or death<\/div>\r\n<div>\u2022Discrete from disease and disability<\/div>\r\n<div>\u2022Often chronic and progressive but can be dynamic and potentially reversible<\/div>\r\nFrailty = Increased vulnerability + stressor --&gt; adverse event[footnote]Allison et al., 2021[\/footnote][footnote]Canadian Frailty Network, 2018[\/footnote][footnote]CGA Toolkit, n.d.-a[\/footnote][footnote]Fried et al., 2001[\/footnote]\r\n\r\nFrailty Screening Tools:\r\n<div>Frail NH \u2013 Simplifies Frailty Screening Screens Residents at Bedside<\/div>\r\n<div>Frailty Index \u2013 Predicts outcomes in communities<\/div>\r\n<div>Edmonton Frail Scale \u2013 Valid, multidimensional reliable index to measure alterations related to frailty<\/div>\r\n<div>Clinical Frailty Scale \u2013 Clinical use, judgement based tool to screen for frailty and degrees of fitness and frailty<\/div>\r\n<div>Functional Assessment Staging Tool (FAST Scale) \u2013 Functional assessment especially in residents with dementia.<\/div>\r\n<div>Gerontopole Frailty Screening Tool (GFST) \u2013 Scale that directly focuses on signs and symptoms of frailty<\/div>\r\n<div>Timed Up and Go Test (TUG) \u2013 To assess mobility and risk for falls[footnote]Van Kan et al., 2008[\/footnote][footnote]Cowles, n.d[\/footnote][footnote]Rolfon et al., 2006[\/footnote][footnote]Rockwood et al., 2005[\/footnote][footnote]Sukkriana &amp; Punsawad, 2020[\/footnote][footnote]CDC, 2017[\/footnote][footnote]Geriatric Medicine Research, n.d.[\/footnote][footnote]Clegg et al., 2013[\/footnote]<\/div>\r\n<div>\r\n\r\nManagement of Frailty:\r\n<ul>\r\n \t<li>No recommendations to screen for frailty<\/li>\r\n \t<li>Identifying frailty at an earlier stage can be challenging and is best complemented with the use of valid, reliable tools<\/li>\r\n \t<li>Multicomponent interventions should be based on\r\n<ul>\r\n \t<li>Health needs, priorities and level of frailty, with involvement of various team members<\/li>\r\n \t<li>Include care and support planning<\/li>\r\n \t<li>Physical activity<\/li>\r\n \t<li>Dietary interventions<\/li>\r\n \t<li>Structured medication reviews<\/li>\r\n \t<li>Strengthening social networks[footnote]Abbasi et al., 2018[\/footnote][footnote]Meneilly et al., 2018[\/footnote]<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/div>","rendered":"<p>Frailty as a Syndrome<\/p>\n<div>\u2022Frailty is a complex clinical syndrome with multiple causes and contributors characterized by:<\/div>\n<div>\u2022Diminished strength<\/div>\n<div>\u2022Decreased endurance<\/div>\n<div>\u2022Reduced physiologic function<\/div>\n<div>\u2022Increases an individual&#8217;s vulnerability for developing increased dependency and\/or death<\/div>\n<div>\u2022Discrete from disease and disability<\/div>\n<div>\u2022Often chronic and progressive but can be dynamic and potentially reversible<\/div>\n<p>Frailty = Increased vulnerability + stressor &#8211;&gt; adverse event<a class=\"footnote\" title=\"Allison et al., 2021\" id=\"return-footnote-1096-1\" href=\"#footnote-1096-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a><a class=\"footnote\" title=\"Canadian Frailty Network, 2018\" id=\"return-footnote-1096-2\" href=\"#footnote-1096-2\" aria-label=\"Footnote 2\"><sup class=\"footnote\">[2]<\/sup><\/a><a class=\"footnote\" title=\"CGA Toolkit, n.d.-a\" id=\"return-footnote-1096-3\" href=\"#footnote-1096-3\" aria-label=\"Footnote 3\"><sup class=\"footnote\">[3]<\/sup><\/a><a class=\"footnote\" title=\"Fried et al., 2001\" id=\"return-footnote-1096-4\" href=\"#footnote-1096-4\" aria-label=\"Footnote 4\"><sup class=\"footnote\">[4]<\/sup><\/a><\/p>\n<p>Frailty Screening Tools:<\/p>\n<div>Frail NH \u2013 Simplifies Frailty Screening Screens Residents at Bedside<\/div>\n<div>Frailty Index \u2013 Predicts outcomes in communities<\/div>\n<div>Edmonton Frail Scale \u2013 Valid, multidimensional reliable index to measure alterations related to frailty<\/div>\n<div>Clinical Frailty Scale \u2013 Clinical use, judgement based tool to screen for frailty and degrees of fitness and frailty<\/div>\n<div>Functional Assessment Staging Tool (FAST Scale) \u2013 Functional assessment especially in residents with dementia.<\/div>\n<div>Gerontopole Frailty Screening Tool (GFST) \u2013 Scale that directly focuses on signs and symptoms of frailty<\/div>\n<div>Timed Up and Go Test (TUG) \u2013 To assess mobility and risk for falls<a class=\"footnote\" title=\"Van Kan et al., 2008\" id=\"return-footnote-1096-5\" href=\"#footnote-1096-5\" aria-label=\"Footnote 5\"><sup class=\"footnote\">[5]<\/sup><\/a><a class=\"footnote\" title=\"Cowles, n.d\" id=\"return-footnote-1096-6\" href=\"#footnote-1096-6\" aria-label=\"Footnote 6\"><sup class=\"footnote\">[6]<\/sup><\/a><a class=\"footnote\" title=\"Rolfon et al., 2006\" id=\"return-footnote-1096-7\" href=\"#footnote-1096-7\" aria-label=\"Footnote 7\"><sup class=\"footnote\">[7]<\/sup><\/a><a class=\"footnote\" title=\"Rockwood et al., 2005\" id=\"return-footnote-1096-8\" href=\"#footnote-1096-8\" aria-label=\"Footnote 8\"><sup class=\"footnote\">[8]<\/sup><\/a><a class=\"footnote\" title=\"Sukkriana &amp; Punsawad, 2020\" id=\"return-footnote-1096-9\" href=\"#footnote-1096-9\" aria-label=\"Footnote 9\"><sup class=\"footnote\">[9]<\/sup><\/a><a class=\"footnote\" title=\"CDC, 2017\" id=\"return-footnote-1096-10\" href=\"#footnote-1096-10\" aria-label=\"Footnote 10\"><sup class=\"footnote\">[10]<\/sup><\/a><a class=\"footnote\" title=\"Geriatric Medicine Research, n.d.\" id=\"return-footnote-1096-11\" href=\"#footnote-1096-11\" aria-label=\"Footnote 11\"><sup class=\"footnote\">[11]<\/sup><\/a><a class=\"footnote\" title=\"Clegg et al., 2013\" id=\"return-footnote-1096-12\" href=\"#footnote-1096-12\" aria-label=\"Footnote 12\"><sup class=\"footnote\">[12]<\/sup><\/a><\/div>\n<div>\n<p>Management of Frailty:<\/p>\n<ul>\n<li>No recommendations to screen for frailty<\/li>\n<li>Identifying frailty at an earlier stage can be challenging and is best complemented with the use of valid, reliable tools<\/li>\n<li>Multicomponent interventions should be based on\n<ul>\n<li>Health needs, priorities and level of frailty, with involvement of various team members<\/li>\n<li>Include care and support planning<\/li>\n<li>Physical activity<\/li>\n<li>Dietary interventions<\/li>\n<li>Structured medication reviews<\/li>\n<li>Strengthening social networks<a class=\"footnote\" title=\"Abbasi et al., 2018\" id=\"return-footnote-1096-13\" href=\"#footnote-1096-13\" aria-label=\"Footnote 13\"><sup class=\"footnote\">[13]<\/sup><\/a><a class=\"footnote\" title=\"Meneilly et al., 2018\" id=\"return-footnote-1096-14\" href=\"#footnote-1096-14\" aria-label=\"Footnote 14\"><sup class=\"footnote\">[14]<\/sup><\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-1096-1\">Allison et al., 2021 <a href=\"#return-footnote-1096-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><li id=\"footnote-1096-2\">Canadian Frailty Network, 2018 <a href=\"#return-footnote-1096-2\" class=\"return-footnote\" aria-label=\"Return to footnote 2\">&crarr;<\/a><\/li><li id=\"footnote-1096-3\">CGA Toolkit, n.d.-a <a href=\"#return-footnote-1096-3\" class=\"return-footnote\" aria-label=\"Return to footnote 3\">&crarr;<\/a><\/li><li id=\"footnote-1096-4\">Fried et al., 2001 <a href=\"#return-footnote-1096-4\" class=\"return-footnote\" aria-label=\"Return to footnote 4\">&crarr;<\/a><\/li><li id=\"footnote-1096-5\">Van Kan et al., 2008 <a href=\"#return-footnote-1096-5\" class=\"return-footnote\" aria-label=\"Return to footnote 5\">&crarr;<\/a><\/li><li id=\"footnote-1096-6\">Cowles, n.d <a href=\"#return-footnote-1096-6\" class=\"return-footnote\" aria-label=\"Return to footnote 6\">&crarr;<\/a><\/li><li id=\"footnote-1096-7\">Rolfon et al., 2006 <a href=\"#return-footnote-1096-7\" class=\"return-footnote\" aria-label=\"Return to footnote 7\">&crarr;<\/a><\/li><li id=\"footnote-1096-8\">Rockwood et al., 2005 <a href=\"#return-footnote-1096-8\" class=\"return-footnote\" aria-label=\"Return to footnote 8\">&crarr;<\/a><\/li><li id=\"footnote-1096-9\">Sukkriana &amp; Punsawad, 2020 <a href=\"#return-footnote-1096-9\" class=\"return-footnote\" aria-label=\"Return to footnote 9\">&crarr;<\/a><\/li><li id=\"footnote-1096-10\">CDC, 2017 <a href=\"#return-footnote-1096-10\" class=\"return-footnote\" aria-label=\"Return to footnote 10\">&crarr;<\/a><\/li><li id=\"footnote-1096-11\">Geriatric Medicine Research, n.d. <a href=\"#return-footnote-1096-11\" class=\"return-footnote\" aria-label=\"Return to footnote 11\">&crarr;<\/a><\/li><li id=\"footnote-1096-12\">Clegg et al., 2013 <a href=\"#return-footnote-1096-12\" class=\"return-footnote\" aria-label=\"Return to footnote 12\">&crarr;<\/a><\/li><li id=\"footnote-1096-13\">Abbasi et al., 2018 <a href=\"#return-footnote-1096-13\" class=\"return-footnote\" aria-label=\"Return to footnote 13\">&crarr;<\/a><\/li><li id=\"footnote-1096-14\">Meneilly et al., 2018 <a href=\"#return-footnote-1096-14\" class=\"return-footnote\" aria-label=\"Return to footnote 14\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":517,"menu_order":40,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-1096","chapter","type-chapter","status-publish","hentry"],"part":3,"_links":{"self":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/1096","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/users\/517"}],"version-history":[{"count":1,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/1096\/revisions"}],"predecessor-version":[{"id":1097,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/1096\/revisions\/1097"}],"part":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/parts\/3"}],"metadata":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/1096\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/media?parent=1096"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapter-type?post=1096"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/contributor?post=1096"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/license?post=1096"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}