Define frailty
mutisystem dysregulation, leading to loss of physiological reserve, resulting in a state of increased vulnerability to stressors
What are the two models of frailty and who developed them?
- Fried’s phenotype model
2. Deficit accumulation – Rockwood
Describe Fried’s phenotype score
3 out of 5 needed to be frail (2 = pre-frail) • Unintentional weight loss • Self-reported exhaustion • Weakness – measured by grip strength • Slow walking speed • Low physical activity
What measures are based on the deficit accumulation model?
- Clinical frailty score - developed by Rockwood
2. e frailty index - Clegg et al. 2016
How would you manage someone with mild frailty?
- exercise
- smoking cessation, reduce alcohol
- reduce social isolation
- housing adaptations
How would you manage someone with moderate frailty?
- medication review
- falls management
- primary care MDT
- advanced care planning
- immunisation
How would you manage someone with severe frailty?
- community geriatric services
- carers and carers support
- advance care planning
- bed based intermediate care eg frailty units or rapid response team
- palliative care
What clinical measures are used to measure frailty?
Timed up and go
or
Walking speed
What is timed up and go and what is a normal result?
Get up out of an arm chair, walk 3m and turn round and sit back down on the chair.
<12 seconds
What is an abnormal result for walking speed?
walking less than 0.8ms
less than 4m in 5 seconds
What are the complications of frailty?
delirium falls pressure ulcers inadequate nutrition hospital admissions, increased length of stay residential care mortality
