Frailty

What is it?

Frailty is related to the ageing process, that is, simply getting older.¹

Frailty may cause:

• You to take longer to get over illnesses.
• An illness to be more serious for you.
• You to take longer to complete some activities.

To understand frailty, we must also think about ageing. Ageing is time passing and getting older. With time our bodies gradually change. For some people alongside ageing they become frail.

This change in our way of coping can mean that a minor problem, e.g. constipation, for someone who is frail, could become a serious illness. Often older people have long term health problems, e.g. diabetes or heart failure, which add into their ageing and add to their frailty.

How might it affect me?

These are things you might notice as a sign of increasing frailty:

• Unplanned weight loss*.
• Tiredness/Exhaustion.
• Becoming more affected by the side effects of medications.
• Slowing down.
• Reduced strength.
• More hospital admissions.

*Discuss any unplanned weight loss with your doctor as this could also be a sign of cancer.

Is there a test for frailty?

No, there is not one test for frailty. There are a few tests that your doctor might do when thinking about frailty:

• Timed ‘up and go’ test (how long it takes to stand up from a chair, walk 3m, turn around and sit back down).³
• Frailty Scores (e.g. Rockwood Clinical Frailty Scale – a guide to judge frailty).⁴
• Gait speed (the time it takes to walk a certain distance)⁵
• Grip strength (this is the measure of how tightly you can squeeze something).⁶

The Comprehensive Geriatric Assessment is the name of all the parts of the review from your doctor and multi-disciplinary healthcare team or ‘MDT’.

What can my doctor do about frailty?

Frailty may get worse, but the right support can often make it a little better. Geriatricians (doctors for older people) are experts at reviewing frailty. Your doctor will try to find the best options for you by looking at:

• All of your health problems.
• All of your medication.
• What is important to you.

The doctor may refer you to other professionals such as:

• Specialist nurses – e.g. continence nurses, tissue viability nurses.
• Physiotherapists – to help with mobility.
• Dietitians.
• Occupational therapists – e.g. to help with aids in the home like handrails.
• Mental Health teams.
• Memory services.
• Social workers – e.g. for carers or respite support for your family.

Thinking about the future

Your doctor may want to talk to you about what you want to happen in the future if you were to get more unwell. It is good to think about this, so that you can tell people what you want and have control.

Your doctor may discuss your health problems and write an ‘Emergency Health Care Plan’ with you. Some people like to think about where and how they want to live, make a Will, and may appoint a Lasting Power of Attorney (someone who would act on your behalf if you could not say for yourself).

For more information you can look at the NHS ‘Deciding Right’ leaflet or website.

What can I do about frailty?

These are things that you can do to help improve frailty:

• Try to be active each day.
• Exercise.
• Socialise with other people regularly.
• Stop Smoking.
• Reduce how much alcohol you drink.
• Eat a balanced diet.
• Maintain a healthy weight.

Helpful links:

Ageuk.org.uk

Age UK is a charity dedicated to providing advice and support for older people. This includes information about health and wellbeing, tax and benefits, carers, local social groups and some medical problems.

Dementiauk.org

Dementia UK is a charity committed to supporting people with dementia and those looking after people with dementia. 

NHS Deciding right

Deciding right is specifically designed to help you plan ahead and make choices now for a possible situation in the future when you no longer have the ability (and capacity) to make those choices.

References

1. NHS England (2013) Frailty – What it means and how to keep well over the Winter months. https://www.england.nhs.uk/blog/frailty/ (accessed 04.06.24)
2. Henry Woodford, Essential Geriatrics, Fourth Edition, 2022, CRC Press.
3. RW, Bohannon. (2006). Reference values for the timed up and go test: a descriptive meta-analysis. J Geriatric Phys Ther, 29(2):64-8.
4. Rockwood, K, et al. (2005). A global clinical measure of fitness and frailty in elderly people. CMAJ, 173:489-495.
5. Van Kan GA, Rolland Y, Houles M, et al. The assessment of frailty in older adults. Clin Geriatric Med, 2010; 26:275-86.
6. Spiegowski D, M. L. (2022). The Utility of Grip Strength as a Simplified Measure of Frailty in the Older Adult in the Preoperative Clinic. Cureus, 14(9):e28747.

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

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Telephone: 01642 624719

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