Frailty affects a person’s ability to recover from a clinical episode, their resilience, and function across multiple body systems. Frailty increases as we age.
Older people who are frail often experience poor health, falls and disability as well as longer stays in hospital and increased mortality.1
Older people who are frail can have difficulty coping with minor illnesses and events, such as infections and constipation, and they can be more susceptible to side effects from certain medications. They are more likely to have difficulty recovering from surgery and periods of acute hospitalisation or rehabilitation.
We should identify and respond to a frail older person’s vulnerabilities during their admission to reduce their risk of functional decline so that people don't just survive hospital, but make a full recovery.
Signs of frailty can be obvious or subtle
While some signs of frailty and risk of frailty are obvious, others are not. Common presentations of frailty2 include:
non-specific signs - extreme fatigue, unexplained weight loss, frequent infections
- falls - frequent falls, fear of falling, restricted activity
delirium - acute changes to their cognition
fluctuating disability - day-to-day variation in ability to look after oneself, for example a loss of interest in food, difficulty getting dressed, experiencing good and bad days.
1. Xue, Q.L., The frailty syndrome: definition and natural history. Clinics in Geriatric Medicine, 2011. 27(1): pp. 1-15.
2. Clegg, A., J. Young, S. Iliffe, M. Olde Rikkert, and K. Rockwood, Frailty in elderly people. Lancet, 2013. 381(9868): pp. 752-762.