Elderly and frailty in the emergency department

The frailty framework

Frailty is a state of reduced physiological reserve and increased vulnerability to stressors. The Clinical Frailty Scale runs 1 (very fit) to 9 (terminally ill).^[3] Score 5 or above indicates clinical frailty, predicting mortality, complications and institutional care.^[1][3] The Fried phenotype (unintentional weight loss, exhaustion, weakness, slow gait, low activity — frail if three or more present) and the deficit-accumulation Frailty Index are alternatives, but the CFS is the ED-ready tool.^[5][1]

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References5ShowHide

1. [1]Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people CMAJ, 2005.PMID 16129869
2. [2]Smyth H, Breslin D, Mullany L, et al. Silver Trauma Review Clinic: a novel model of care to manage non-operative injuries in older patients. Emerg Med J, 2023.PMID 37640437
3. [3]Church S, Rogers E, et al. A scoping review of the Clinical Frailty Scale. BMC Geriatr, 2020.PMID 33028215
4. [4]Nakayama A, Major G, et al. Evidence of effectiveness of a fracture liaison service to reduce the re-fracture rate. Osteoporos Int, 2016.PMID 26650377
5. [5]Fried LP, Tangen CM, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci, 2001.PMID 11253156