A lot of debate exists around which frailty measurement is best. Maybe we need two separate measurements - one for population health screening, and one for clinical assessment? Let me know what you think.
Cheers,
Elsa
That's a good question. Can you please elaborate on the debate for those of us who are not doing health research? Why can't we use the same measurement (such as grip-strengt) to assess both good health and frailty in clinical populations?
Hi Elsa:
Wow - great question, and an ongoing reconsideration should also be undertaken.
#1 - I believe the next 5 years may deliver substantial increase in life span. I don't have a feel for if this will also deliver increased or equivalent well being - and so I vote yes.
#2 - An increase in lifespan brings many questions. Commitment to nursing homes may require adjustment, often balance issues are the result of un-resolved infection & and one would expect to see an increase in this risk. Assessment of flexibility as related to stride length needs to be tightly evaluated. What choices will need to be made in regards to prison population if life span increases substantially must be reviewed well in advance in anticipation of likely needed changes in sentencing and evaluation of incarceration costs.
#3 - Frailty needs to be assessed as to risk of infection from minor trauma, fall risk, grip strength, consideration of robotic transport ( independent living potential ), mental capability in self monitoring......
There are many questions to ask.
Fraility is one of the most recent advanced topics emerging from gerontology with persons living longer. Diagnosing this has proven difficult as there are current 5 criteria for its diagnosis (FRAIL pneumonic) which encompass domins of : slowness, weakness, decreased exercise tolerance, unexplained weight loss, easy exhaustion. These criteria can be difficult to obtain in practice especially with weakness and slowness.
I believe that 2 different criteria should not be used but the existing criteria should be modified (making criteria easily measurable) so that clinicians and general population can use the same scale. Two different criteria would be difficult.
Perhaps the paper below goes some way towards answering this question?
If primary care clinicians don't have time during a given visit/health check - at least in countries where health systems have moved to electronic records - a system-based approach could be instituted so that health records are reviewed to flag high-risk patients?
Clegg, et al. Development and validation of an electronic frailty index using routine primary care electronic health record data. Age Ageing. 2016. doi: 10.1093/ageing/afw039
Prof Rockwood also thought of this idea of screening via e-Health records at: http://ageing.oxfordjournals.org/content/45/3/328.extract
Screening for grades of frailty using electronic health records: where do we go from here? Age Ageing (2016) 45 (3): 328-329. doi: 10.1093/ageing/afw057
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