Oral Presentation 29th Australian and New Zealand Bone and Mineral Society Annual Scientific Meeting 2019

Addressing frailty in clinical practice: an evidence based approach (#64)

Susan Kurrle 1
  1. University of Sydney, Hornsby, NEW SOUTH WALES, Australia

In geriatric medicine frailty has recently moved from being a descriptive word that was used frequently but not always accurately, to a condition that it is now quite well defined. Frailty may be viewed as a state of increased vulnerability due to accumulated deficits 1, or a phenotype represented by unexplained weight loss, slow walking speed, low handgrip strength, self reported exhaustion and low physical activity 2 . Its presence has been linked to a number of adverse outcomes including disability, institutionalisation and death 2.  A number of studies have shown that frailty is treatable 3,4. Successful interventions include targeted exercise programs, nutritional modification, and other components depending on individual needs 5. This presentation reviews the results of trials which have intervened in older people with phenotypically defined frailty, and looks at the interventions that have been successful. It discusses how these findings might be used in the recognition and management of older people with frailty in clinical practice, including the usefulness and validity of screening instruments 6.

  1. Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005; 173: 489–95.
  2. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001; 56: M146–56.
  3. Cameron ID, Fairhall N, Langron C et al. A multifactorial interdisciplinary intervention reduces frailty in older people: randomised trial. BMC Medicine 2013, 11: 65.
  4. Ng TP, Feng L, Nyunt MSZ, et al. Nutritional, physical, cognitive, and combination interventions and frailty reversal among older adults: a randomized controlled trial. Am J Med 2015; 128, 1225-1236.
  5. Fairhall N, Langron C, Sherrington C et al. Treating frailty: A practical guide. BMC Medicine 2011; MS 24568154645134883.
  6. Morley JE, Vellas B, Abellan van Kan G et al. Frailty consensus: a call to action. J Am Med Dir Assoc 2013; 14(6): 392-397.