Clinical Frailty Scale

Priya Mendiratta, Caroline Schoo, Rafay Latif, Priya Mendiratta, Caroline Schoo, Rafay Latif

Excerpt

Across the globe, the geriatric population is increasing, making frailty a concern of increasing importance for healthcare systems. Frailty is a multidimensional geriatric syndrome associated with poor health outcomes and will continue to place a substantial and increasing burden on healthcare systems. Frailty represents a decreased physiologic reserve and function that is more prevalent with increasing age. It is characterized by increasing vulnerability to physiologic stressors.

Frailty is the result of cumulative cellular damage from diverse etiologies over the life of the individual—typical aging results in loss of homeostatic reserve in physiological systems. However, despite the loss of these reserves, many individuals still function well with aging. Any stress or insult to these physiologic reserves can result in an older adult decompensating and thus causing increased frailty. Patients can be categorized as robust, pre-frail, or frail, depending on the degree of physiological and functional decline.

Frailty can develop due to factors such as (i) socio-demographic influences (e.g. poverty, living alone, low education level); (ii) psychological factors (e.g. depression); (iii) nutritional issues (e.g. malnutrition); (iv) polypharmacy; (v) diseases and complications (inflammatory states, cancer, endocrine disorders, dementia); and (v) low physical activity. Despite the importance of frailty, there is currently no internationally recognized standard definition due to its complex etiology and the inherent difficulty in distinguishing frailty from both aging and disability. Irrespective of definitions, it is clear that frailty is an important geriatric syndrome, which is dynamic, fluctuates over time, and reflects multisystem dysfunction. Given its importance, since the mid-1990s, frailty scores have been developed to help quantify the degree of disability from frailty.

Conflict of interest statement

Disclosure: Priya Mendiratta declares no relevant financial relationships with ineligible companies.

Disclosure: Caroline Schoo declares no relevant financial relationships with ineligible companies.

Disclosure: Rafay Latif declares no relevant financial relationships with ineligible companies.

Copyright © 2023, StatPearls Publishing LLC.

References

    1. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013 Mar 02;381(9868):752-62.
    1. Pugh RJ, Lone NI. Frailty Screening in Critical Care at Scale. Chest. 2021 Oct;160(4):1165-1166.
    1. Lee H, Lee E, Jang IY. Frailty and Comprehensive Geriatric Assessment. J Korean Med Sci. 2020 Jan 20;35(3):e16.
    1. Di Ciaula A, Portincasa P. The environment as a determinant of successful aging or frailty. Mech Ageing Dev. 2020 Jun;188:111244.
    1. Darvall JN, Bellomo R, Paul E, Bailey M, Young PJ, Reid A, Rockwood K, Pilcher D. Routine Frailty Screening in Critical Illness: A Population-Based Cohort Study in Australia and New Zealand. Chest. 2021 Oct;160(4):1292-1303.
    1. Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, Mitnitski A. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005 Aug 30;173(5):489-95.
    1. Basic D, Shanley C. Frailty in an older inpatient population: using the clinical frailty scale to predict patient outcomes. J Aging Health. 2015 Jun;27(4):670-85.
    1. Wallis SJ, Wall J, Biram RW, Romero-Ortuno R. Association of the clinical frailty scale with hospital outcomes. QJM. 2015 Dec;108(12):943-9.
    1. Dunne MJ, Abah U, Scarci M. Frailty assessment in thoracic surgery. Interact Cardiovasc Thorac Surg. 2014 May;18(5):667-70.
    1. Oviedo-Briones M, Laso ÁR, Carnicero JA, Cesari M, Grodzicki T, Gryglewska B, Sinclair A, Landi F, Vellas B, Checa-López M, Rodriguez-Mañas L. A Comparison of Frailty Assessment Instruments in Different Clinical and Social Care Settings: The Frailtools Project. J Am Med Dir Assoc. 2021 Mar;22(3):607.e7-607.e12.
    1. Subramaniam A, Ueno R, Tiruvoipati R, Srikanth V, Bailey M, Pilcher D. Comparison of the predictive ability of clinical frailty scale and hospital frailty risk score to determine long-term survival in critically ill patients: a multicentre retrospective cohort study. Crit Care. 2022 May 03;26(1):121.
    1. Aucoin SD, Hao M, Sohi R, Shaw J, Bentov I, Walker D, McIsaac DI. Accuracy and Feasibility of Clinically Applied Frailty Instruments before Surgery: A Systematic Review and Meta-analysis. Anesthesiology. 2020 Jul;133(1):78-95.
    1. Pranata R, Henrina J, Lim MA, Lawrensia S, Yonas E, Vania R, Huang I, Lukito AA, Suastika K, Kuswardhani RAT, Setiati S. Clinical frailty scale and mortality in COVID-19: A systematic review and dose-response meta-analysis. Arch Gerontol Geriatr. 2021 Mar-Apr;93:104324.
    1. Elliott A, Taub N, Banerjee J, Aijaz F, Jones W, Teece L, van Oppen J, Conroy S. Does the Clinical Frailty Scale at Triage Predict Outcomes From Emergency Care for Older People? Ann Emerg Med. 2021 Jun;77(6):620-627.
    1. Papageorgiou D, Kosenai K, Gika E, Alefragkis D, Keskou D, Mandila C. Quantification of Frailty Syndrome in ICU Patients with Clinical Frailty Scale. Folia Med (Plovdiv) 2020 Dec 31;62(4):655-661.
    1. Atkins CGK, Das S. A Critique of the Use of the Clinical Frailty Scale in Triage. Am J Bioeth. 2021 Nov;21(11):67-68.
    1. Marengoni A, Zucchelli A, Vetrano DL, Aloisi G, Brandi V, Ciutan M, Panait CL, Bernabei R, Onder G, Palmer K. Heart failure, frailty, and pre-frailty: A systematic review and meta-analysis of observational studies. Int J Cardiol. 2020 Oct 01;316:161-171.

Source: PubMed

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