Consensus: Screen for Frailty in Patients Over 70 Years Old

Larry Hand

June 05, 2013

Clinicians should screen all patients over 70 years old for frailty, a condition that is potentially deadly but is also easily treatable, according to an article published online June 5 in the Journal of the American Medical Directors Association.

John E. Morley, MD, from the Division of Geriatric Medicine, St. Louis University School of Medicine, Missouri, and colleagues compiled a statement reached during a meeting of 6 major international and US societies. The meeting was convened in Orlando, Florida, on December 7, 2012. Experts on frailty also attended the meeting.

Attendees at the meeting reached a consensus on the definition of physical frailty: "a medical syndrome with multiple causes and contributors that is characterized by diminished strength, endurance, and reduced physiologic function that increases an individual's vulnerability for developing dependency and/or death."

In addition to agreeing that all patients over 70 should be screened, the group agreed on 3 key further points:

  1. Frailty is a important medical condition;

  2. Rapid screening tests have been developed and validated for recognizing frailty; and

  3. The condition can be treated with modalities such as exercise, protein, and vitamin supplementation and by reducing multiple prescription medicines.

They note, for example, that one test, the FRAIL tool, is a simple questionnaire that asks about such things as recent weight loss and difficulty walking up stairs.

"Frailty is extraordinarily common, affecting between 5 and 10 percent of those who are older than 70. Women are more likely to be frail than men," Dr. Morley said in a news release. "Over a period of time, frailty leads to increased death rates, poor function and increased hospitalizations. It's treatable and we're asking doctors to spend 15 seconds to conduct a screening that could prevent bad outcomes."

Sufficient evidence exists for the need to screen people older than age 70 years for frailty, the group agreed. Moreover, screening is noninvasive and may reveal conditions that can be treated.

They conclude, "To successfully combat frailty, our medical practice must be targeted, strong, and sustained. With the aging of our population, we cannot wait and must implement the screening and management of frailty into clinical practice worldwide."

The research was supported by unrestricted educational grants from Sanofi and Nutricia Advance Medical Nutrition. The authors have disclosed no relevant financial relationships.

J Am Med Dir Assoc. Published online June 5, 2013. Abstract

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