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For further information, see CMDT Part 4-3: Comprehensive Assessment of the Older Adult

Key Features

  • Characterized by loss of physiologic reserve and dysregulation across multiple systems, ultimately resulting in greater risk of poor health outcomes

  • Estimates of its prevalence in community-dwelling older adults range from 5% to 17%

  • Persons with frailty are at increased risk for

    • Falls

    • Hospitalization

    • Functional decline

    • Poorer outcomes associated with medical interventions (eg, surgery, dialysis, chemotherapy)

    • Death

Clinical Findings

  • Weakness (grip strength)

  • Slow gait speed

  • Decreased physical activity

  • Weight loss

  • Exhaustion or low energy

Diagnosis

  • Diagnosis is made when three or more of the above clinical features are present

  • However, there is not one universally agreed upon definition or assessment tool for frailty

Treatment

  • Exercise, particularly strength and resistance training, can increase walking speed and improve function

  • Optimal nutrition, particularly higher levels of protein intake, may be associated with reduced incidence of frailty

  • Treatment is largely supportive, multifactorial, and individualized based on patient goals, life expectancy, and chronic conditions once frailty is established

  • When irreversible complications from frailty develop, comfort-focused or hospice care is appropriate

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