Implementing frailty into clinical practice: we cannot wait
Vellas B, Cestac P, Moley JE
J Nutr Health Aging 2012;16:599-600.
Publication date: August 1, 2012
Since the 1980s, geriatric medicine has expanded to the point that there are acute care units, mobile teams, day hospitals, and other clinics available to older patients. However, in most cases physicians are more frequently facing patients who present with already severe disabilities at a stage where effective treatment may be limited. Nearly 95% of the geriatric clinical force accounts for older adults who are already dependent.
In this article by Vellas and colleagues, the authors reiterate the need to continue to take care of these elderly patients with severe disabilities, but they also underscore the need to assess risk for pre-frailty and frailty as well. The authors suggest an approach to interventions for assessing and managing frailty, an approach that involves several parameters. First, the intervention needs to target both pre-frail and frail older adults, particularly through implementation of a simple tool that can be used easily by family practitioners to assess frailty risk. Second, it must be a clinically important intervention, i.e. it must have a real and significant impact on clinical practice. Finally, it must be sustainable due to growing aging populations and the long period of time that one may be considered frail.