Rowe JW, Fried LP

J Frailty Aging 2013;2:126-7

Publication date: September 1, 2013


In the context of a rapidly growing interest in frailty, the authors identify several valuable strategies for inclusion of special attention to the syndrome in the clinical care of older persons as well as a number of specific clinical research opportunities.

Recognition of the importance and prevalence of frailty, and its various stages, is crucial to the effective management of geriatric patients. Just as geriatric care routinely includes screening for cognitive impairment, screening for frailty should be incorporated into patients’ regular evaluations.

In clinical studies involving older patients, individuals should be routinely characterized as to their frailty status, as this may be an important determinant of their response to the various interventions.

Clinical research opportunities in frailty include:

  • the best patient selection and ‘dose’ of currently recommended treatments (exercise, nutritional supplementation, Vitamin D ) and optimal treatment combinations- and how to titrate to clinical status and stage of frailty
  • the natural history, with a focus on identification of factors that may initiate the pathway to frailty;•
  • recognition of the late stage of frailty which is not responsive to treatment, and is a pre-death phase during which the patients should be eligible for hospice;
  • the impact of frailty on the metabolism, distribution, effectiveness and toxicity of medications;
  • the impact of frailty on recovery from stress, such as hip fracture, major surgery, etc.;
  • design of hospital and other treatment settings to optimize recovery from illness for those who are frail.Journal Website