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Target exams

Red flags

• An older person who is functionally declining — falling, losing weight, or losing independence in ADLs — is frail until proven otherwise, and the frailty is a treatable target, not an inevitable consequence of ageing
• Unintentional weight loss of more than 5 percent in 3 months or more than 10 percent in 6 months in an older person is a red flag for frailty, sarcopenia, malignancy, and depression — investigate, do not reassure
• A slow gait speed — under 0.8 metres per second over 4 metres — is a powerful single predictor of frailty, falls, disability, and mortality, and it should be measured in every geriatric assessment
• An older patient who is admitted to hospital and scores Clinical Frailty Scale 5 or above is at high risk of delirium, falls, pressure injuries, functional decline, institutionalisation, and death — the CFS changes the care plan, not just the paperwork
• Sarcopenia is not the same as frailty, but they overlap — low grip strength (under 27 kg in men, under 16 kg in women) plus low muscle mass on DEXA defines probable sarcopenia by EWGSOP2 and demands protein, resistance exercise, and vitamin D