Frailty Assessment & Management | GCCNurseJobs.com GCC Nursing Platform

Frailty Nursing Guide

Navigate all six modules below — from foundational concepts to GCC exam focus. Each tab is self-contained and examination-ready.

What is Frailty?

Frailty is a state of increased vulnerability to stressors due to decreased physiological reserve across multiple organ systems. It results in poor ability to maintain homeostasis following a stressor event (illness, surgery, medication change, bereavement) and is associated with increased risk of falls, delirium, hospitalisation, and death.

Frailty is not a diagnosis — it is a clinical syndrome and risk state. It is distinct from ageing, but ageing is the strongest risk factor.

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Key concept: Frailty is not the same as disability, disease, or old age — though they frequently co-exist. A 90-year-old marathon runner is not frail. A 65-year-old with severe COPD, sarcopenia, and social isolation may be.

Frailty vs Related Concepts

Normal ageing: gradual physiological decline, but no increased vulnerability to stressors; preserved reserve. Not frailty.
Sarcopenia: loss of skeletal muscle mass and function with age. Sarcopenia is a component of frailty (grip strength, gait speed) but not synonymous — frailty is multidomain.
Disability: difficulty performing activities of daily living. Disability may result from frailty, but frailty can exist without disability (especially pre-frailty). Disability is the downstream consequence.
Multimorbidity: two or more chronic conditions co-existing. Multimorbidity and frailty overlap but are separate constructs — a patient can be frail without multimorbidity (e.g. severe undernutrition) and multimorbid without being frail (e.g. well-controlled hypertension + diabetes).

Fried Frailty Phenotype

5 Criteria (Fried et al. 2001 — CHS study)

1. Unintentional weight loss — ≥4.5 kg or ≥5% body weight in the past year. Ask directly; check previous weights in notes.
2. Exhaustion / Fatigue — self-reported. CES-D depression scale items 7 & 20: "How often in the past week did you feel that everything you did was an effort?" / "felt you could not get going" — response "most of the time" or "moderate amount of time" = positive.
3. Low physical activity — below lowest quintile for gender, assessed by Minnesota Leisure Time Activity questionnaire (kcal/week). Clinically: essentially housebound or very sedentary.
4. Slow gait speed — timed 4–6 metre walk. Cut-offs vary by height and sex (lowest quintile). Approximately ≤0.8 m/s in clinical practice as a marker.
5. Weak grip strength — hand-held dynamometer. Below lowest quintile, adjusted for BMI and sex. Dominant hand, 3 attempts.

Frailty Score Classification

0 criteria Robust — non-frail; standard care
1–2 criteria Pre-frail — high conversion risk; preventable
3–5 criteria Frail — adverse outcomes likely; enhanced care required

Clinical Frailty Scale (CFS) — Rockwood

The most widely used frailty scoring tool internationally and in GCC hospitals. Pictorial 9-point scale based on clinical judgement integrating function, mobility, energy, symptoms, and dependence.

1–2 — Robust / Well (not frail)
3 — Managing well (pre-frail zone)
4–5 — Mild frailty (increased risk)
6–7 — Moderate–Severe frailty
8–9 — Very severe / Terminal

CFS is preferred over Fried in acute care — does not require grip strength or gait testing at the bedside. CFS score >4 is the widely used threshold for "frail".

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GCC Context: Saudi Arabia and UAE have rapidly ageing populations — Vision 2030 eldercare expansion, UAE Longevity Programme. Elderly expats (South Asian, Arab) returning home when frail create a repatriation health burden. Qatar Hamad Medical Corporation, SKMC Abu Dhabi, and KAMC Riyadh all use CFS in geriatric and critical care workflows.

Frailty Prevalence

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Community-Dwelling

Approximately 10% of adults aged >65 in the community are frail. Pre-frailty affects another 40–50%. Prevalence rises steeply with age — up to 25–30% in those >85.

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Hospitalised Elderly

25–50% of elderly patients admitted to hospital are frail. Frailty is associated with longer length of stay, higher readmission rates, and poorer functional discharge outcomes.

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Surgical Patients

Frailty (CFS >4) is associated with 3× higher 30-day mortality and significantly more post-operative complications, delirium, and prolonged rehabilitation needs.

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GCC Populations

GCC elderly carry high diabetes, cardiovascular disease, and CKD burden — accelerating frailty progression. Sedentary lifestyles, heat-related sun avoidance, and obesity compound sarcopenia risk. Systematic frailty screening is now mandated in JCI-accredited GCC hospitals.

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CGA Definition: Comprehensive Geriatric Assessment is a multidimensional, multidisciplinary diagnostic and therapeutic process that identifies medical, functional, cognitive, psychological, social, and environmental problems in older people — enabling a coordinated and integrated care plan. CGA reduces mortality, hospital readmission, and institutionalisation.

CGA Domains

Medical: comorbidities, active problems, medication review (polypharmacy), pain, sensory impairment (vision, hearing)
Functional: ADLs (basic self-care) and IADLs (complex daily activities), mobility, assistive devices
Cognitive: screening for dementia and delirium — MMSE, MoCA, AMT
Psychological: depression, anxiety, grief — GDS-15, mood assessment
Social: support network, carer status, living situation, financial resources
Environmental: home safety assessment, fall hazards, stairs, accessibility
Nutritional: weight loss, appetite, BMI, MNA screen
Advance Care Planning: advance directive, resuscitation wishes, goals of care

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Nursing Role in CGA: Nurses contribute the largest volume of CGA data — they observe function at rest, during hygiene, transfers, and meals. Nursing observations over a shift reveal functional status that no brief assessment tool can capture. Document findings clearly using structured language.

Barthel Index (0–100) — ADL Assessment

Measures independence in 10 basic activities of daily living. Scored 0–100, higher = more independent.

Domain	Max Score
Feeding	10
Bathing	5
Grooming	5
Dressing	10
Bowel control	10
Bladder control	10
Toilet use	10
Transfers (bed↔chair)	15
Mobility on level surface	10
Stairs	10

Cognitive & Psychological Screening

🧠 MMSE — Mini Mental State Examination (0–30) +

The MMSE is the most widely used cognitive screening tool globally. It takes approximately 10 minutes and tests orientation (10), registration (3), attention/calculation (5), recall (3), language (8), visuospatial (1).

27–30 — Normal cognition
21–26 — Mild cognitive impairment (MCI) — warrants MoCA and specialist review
10–20 — Moderate dementia
<10 — Severe dementia

Limitation: MMSE is not sensitive enough to detect mild cognitive impairment or early dementia. Education, language, and cultural factors affect score. In GCC, language barriers (non-Arabic-speaking patients, dialectal variation) can affect validity — use interpreter or translated version when available.

🧠 MoCA — Montreal Cognitive Assessment (0–30) +

MoCA is more sensitive than MMSE for mild cognitive impairment (MCI). It adds executive function, visuoconstructional tasks, and verbal fluency — areas missed by MMSE. Takes 10–15 minutes.

Score ≥26 = normal (add 1 point for <12 years education)
Score 18–25 = mild cognitive impairment
Score 10–17 = moderate cognitive impairment
Score <10 = severe impairment

GCC use: Arabic and Urdu validated translations of MoCA exist. Preferred over MMSE for detecting early dementia/MCI in frail elderly admitted for acute illness. MoCA is free for clinical use (moca-test.com).

💕 GDS-15 — Geriatric Depression Scale (Short Form) +

15-item yes/no questionnaire designed specifically for older adults. Avoids somatic symptoms (sleep, appetite) that can inflate depression scores in elderly with physical illness. Validated in many languages including Arabic.

Score 0–4 = normal / not depressed
Score 5–8 = mild depression — requires further assessment
Score 9–11 = moderate depression — refer to psychology/psychiatry
Score 12–15 = severe depression — urgent referral

Note: Depression is prevalent in frail elderly and worsens frailty — it is both a cause and consequence. Always screen at admission and reassess post-illness. Depression is underdiagnosed in GCC elderly due to cultural stigma around mental health.

🍴 MNA — Mini Nutritional Assessment (Elderly-Specific) +

The MNA is the gold standard nutritional screening tool for older adults. Available in short-form (MNA-SF) for rapid ward screening (0–14) and full-form (0–30) for comprehensive assessment.

MNA-SF <8 — Malnutrition — refer dietitian, commence ONS
MNA-SF 8–11 — At risk of malnutrition — dietary counselling, protein optimisation
MNA-SF 12–14 — Normal nutritional status

Malnutrition and frailty are tightly linked — poor protein intake accelerates sarcopenia. In GCC: Ramadan fasting, cultural dietary patterns, and dental problems all affect nutritional status in elderly patients. Always weigh on admission and weekly thereafter.

📋 CGA Outcome: What Happens Next? +

CGA is not just assessment — it generates a targeted care plan with specific goals:

Rehabilitation goals: physiotherapy and occupational therapy targets — what function can be regained?
Medication optimisation: deprescribing inappropriate drugs, dose adjustment for renal/hepatic function
Social support plan: home care, day centre, carer support, housing assessment
Advance care planning trigger: frailty CFS ≥5 should prompt ACP discussion — goals of care, resuscitation preferences, hospital avoidance planning
Specialist referrals: dietitian, speech therapy (dysphagia), optometry, audiology, social work, psychology
Carer education: family involvement in GCC is central — educate family members about frailty management, exercise, falls prevention, medication administration

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Hospitalisation is a hazard event for frail patients. The hospital environment — bed rest, fasting, medications, disrupted sleep, noise, restraints, and procedures — can accelerate deconditioning, trigger delirium, and permanently reduce functional status. Nursing vigilance is the primary defence.

Hospital-Acquired Deconditioning

1 week of bed rest in an older adult = 10% loss of muscle mass
10 days of hospitalisation can undo months of rehabilitation
Deconditioning is the primary driver of the "bounce-back" readmission pattern
Frail patients are at highest risk — reduced physiological reserve means they cannot compensate
Functional decline often occurs before or independent of the presenting diagnosis

HALO Framework — Hospital-Acquired Loss of function Opportunities

H — Help patients sit out of bed for at least 2 hours per day from day 1
A — Ambulate daily — even 5 minutes of walking with supervision is beneficial
L — Leave unnecessary IV lines, catheters, and monitoring off — every tether restricts mobility
O — Occupational therapy early — ADL assessment and rehabilitation planning from day 1

Nursing Mobility Protocol for Frail Patients

Day 1: Sit patient upright for meals; assess mobility with physiotherapy; ensure call bell within reach
Day 2–3: Transfer to chair twice daily; stand at bedside with assistance; encourage self-care in washing/dressing
Day 4+: Supervised ambulation in corridor; progressive distance; reassess with physiotherapy for walking aid
Document mobility level using standardised scale (e.g. DEMMI, FIM)
Refer physiotherapy on admission if CFS ≥4

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Nutritional Support: Frail elderly require protein 1.2 g/kg/day minimum (1.5 g/kg/day if recovering from illness or surgery). Commence oral nutritional supplements (ONS) if intake inadequate. Involve dietitian within 24–48 hours. Do not fast frail patients unnecessarily.

Delirium in Frail Patients

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Delirium and frailty are tightly linked. Frail patients have reduced cognitive reserve — even a mild physiological stressor can precipitate delirium. Delirium in turn accelerates functional decline, causes distress, prolongs hospital stay, and is associated with long-term cognitive impairment. Every frail admitted patient should have delirium prevention initiated on day 1.

PINCH ME — Delirium Precipitants (Mnemonic)

Pain

Uncontrolled pain is a major precipitant — assess using PAINAD in non-verbal patients

Infection

UTI, pneumonia, sepsis — often present atypically (no fever, no localising signs) in frail elderly

Nutrition

Thiamine, B12 deficiency; hypoglycaemia; inadequate caloric and protein intake

Constipation

Faecal loading causes significant delirium in elderly — check last bowel movement daily

Hydration

Dehydration and fluid overload both precipitate delirium — monitor intake/output carefully

Medication

New or changed medications — anticholinergics, opioids, benzodiazepines, steroids are highest risk

Environment

Unfamiliar environment, poor lighting, noise, bed changes, disrupted sleep, lack of glasses/hearing aids

Falls in Hospital — STRATIFY Tool

The STRATIFY falls risk assessment tool scores 5 domains: recent falls, agitated, visual impairment, frequent toileting, and transfer/mobility risk. Score ≥2 = high risk.

Frail patients are automatically high risk for falls — do not wait for a score
Implement falls precautions: low bed, bed alarm, non-slip footwear, call bell positioning, frequent toileting rounds
Ensure glasses and hearing aids are with the patient — sensory impairment = falls risk
Post-fall: full assessment, neurological observations, incident report, family notification
Never use physical restraints to prevent falls — increases risk and causes delirium

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Polypharmacy Review — STOPP/START: Frail patients with ≥5 medications should have a structured medicines review. STOPP criteria identify potentially inappropriate prescribing; START identifies omissions. Drug reduction in frail patients reduces falls, delirium, and adverse drug reactions. Document all medication changes and rationale clearly.

Frailty and Surgical Risk

CFS ≥5 = significantly increased 30-day mortality and morbidity
CFS ≥4 is the widely used threshold for triggering enhanced pre-operative assessment
Frailty predicts outcomes better than age alone — a 75-year-old CFS 2 carries less risk than a 65-year-old CFS 6
Emergency surgery in frail patients (e.g. hip fracture, perforated bowel): mortality may be >30% at 30 days for CFS 7–8
Nursing role: screen all surgical patients ≥65 years with CFS on admission; escalate CFS ≥4 to surgical and anaesthetic team immediately

Pre-operative Optimisation — "Prehabilitation"

Exercise prehabilitation: even 2–4 weeks of supervised exercise before elective surgery improves outcomes. Aerobic + resistance training programme.
Nutritional optimisation: protein loading ≥1.5 g/kg/day pre-operatively; oral nutritional supplements if BMI <20 or weight loss >10%
Medication optimisation: hold high-risk drugs pre-operatively (anticoagulants, diuretics, NSAIDs, hypoglycaemics per protocol); review and reduce polypharmacy
Psychological preparation: realistic expectation setting; involve family; address anxiety; ensure advance care planning is documented before surgery
Anaemia correction: optimise haemoglobin before elective surgery

Anaesthetic Considerations in Frailty

Regional anaesthesia preferred over general where possible — spinal, epidural, or nerve block reduces delirium risk, preserves respiratory function
Careful fluid management — frail patients poorly tolerate both fluid overload and hypovolaemia; goal-directed fluid therapy with invasive monitoring where appropriate
Temperature management — frail patients are at high risk of hypothermia intra-operatively; active warming devices throughout
Avoid prolonged fasting — ERAS (Enhanced Recovery After Surgery) protocols: carbohydrate loading 2 hours before, early post-operative feeding
Drug sensitivity: reduced hepatic/renal metabolism — lower doses, longer intervals; avoid long-acting benzodiazepines and anticholinergics

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Post-Operative Delirium: Most common surgical complication in frail elderly. Risk highest in the first 72 hours post-op. Prevention: HELP (Hospital Elder Life Program) — early mobilisation, cognitive engagement, sleep protocol, vision and hearing aids, adequate hydration, pain control. Avoid haloperidol routinely; treat underlying cause first.

ICU Frailty & End-of-Life Decisions

💉 ICU Admission — Using CFS for Decision-Making +

CFS is increasingly used in ICU admission triage and prognosis, particularly in settings with limited resources or mass casualty events:

CFS 1–4: ICU admission generally appropriate if clinical indication exists; reasonable chance of meaningful recovery
CFS 5–6: Careful individualised discussion — goals of care, reversibility, prior functional status, patient wishes
CFS 7–9: ICU admission unlikely to be beneficial; comfort-focused care, palliative care consultation, family meeting required

Important: CFS alone should never be the sole basis for withholding care. It is one factor in a holistic clinical assessment alongside diagnosis, reversibility, patient wishes, and family input.

💔 CPR and Resuscitation in Frailty +

CPR outcomes in frail elderly are very poor:

CFS 7–8: survival to discharge after in-hospital cardiac arrest is extremely low (<5–10% in most studies)
Survivors often have significant neurological or functional deterioration
DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) is a medical decision requiring senior involvement, patient (where capacity exists) and family consultation
DNACPR does not mean withdrawal of active treatment — it means CPR specifically is not in the patient's best interests given the clinical picture

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GCC Cultural Context: DNACPR is not widely accepted or understood in many GCC cultures. Islamic principle of preserving life is paramount, and families may request "everything to be done". Nurses must facilitate sensitive family meetings led by senior medical staff. Advance care planning documentation should be completed electively — not during a crisis. Religious scholars (scholars from Ministry of Islamic Affairs) may be involved to support families in some GCC hospitals.

🕯 Frailty as an Advance Care Planning Trigger +

Any patient with CFS ≥5 or progressive frailty trajectory should have advance care planning (ACP) initiated:

ACP conversation: Explore understanding of condition, fears and hopes, goals of care — conducted by experienced clinician, ideally during a stable period (not during acute admission if possible)
Advance directive (Wasiyya in Arabic): Written documentation of patient wishes — limitations of treatment, preferred place of care
Emergency care plan: Documents agreed escalation ceiling for emergency staff who do not know the patient
Palliative care referral: For CFS 7–8 patients with progressive non-reversible frailty — comfort measures, symptom management, family support
Nursing role: Identify patients who need ACP, document care plan, communicate clearly at handover, advocate for patient's known wishes

Primary Prevention of Frailty

Exercise — the strongest evidence of all interventions. Resistance training + aerobic exercise combination reduces frailty incidence and reverses pre-frailty. Aim ≥150 min/week moderate activity + 2×/week resistance training.
Protein optimisation — dietary protein 1.2–1.5 g/kg/day. Leucine-rich foods (meat, dairy, legumes) stimulate muscle protein synthesis. Evening protein intake particularly beneficial.
Vitamin D — deficiency strongly associated with sarcopenia and frailty. Supplement if serum 25-OHD <50 nmol/L. Paradoxically prevalent in GCC despite abundant sun — due to indoor lifestyles, abaya/full-body cover, and sun avoidance due to extreme heat. Check all elderly patients.
Social engagement — isolation is an independent risk factor for frailty. Social prescription: structured community activities, day centres, volunteering programmes.
Medication review — many medications accelerate frailty: PPI overuse reduces protein absorption; anticholinergics impair cognition and mobility; sedatives cause falls.

Exercise Prescription for Frail Elderly

Progressive resistance training: 2× per week, major muscle groups, starting light and increasing load over weeks. Chair-based resistance exercises for those with limited mobility.
Balance training: Tai Chi, single-leg standing, tandem gait, balance boards. Reduces falls by 20–30% when combined with strength training.
Walking programme: Daily walking, even 10 minutes initially, progressive targets. Pedometer feedback motivates adherence.
Warm water exercise: Hydrotherapy — joint-friendly, reduces pain, improves mobility in those with arthritis (common in GCC elderly).
FITT principle: Frequency (2–3×/week), Intensity (moderate — RPE 4–6/10), Time (20–45 min), Type (mix of resistance + aerobic + balance).

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GCC-Specific Vitamin D Context: Despite living in one of the sunniest regions in the world, vitamin D deficiency affects up to 80% of GCC elderly. Causes: full-body clothing, indoor air-conditioned lifestyle, dark skin pigmentation (reduced synthesis), minimal fortified foods. Routine supplementation (1000–2000 IU daily) recommended in all GCC elderly patients.

Falls Prevention Programme

Multifactorial Falls Prevention Components

Strength and balance exercises — most effective single intervention (Otago programme, FaME programme): reduces falls by 25–35%
Home hazard assessment: loose rugs, poor lighting, wet floors, no grab rails in bathroom. Occupational therapy home visit or nurse-led assessment. In GCC: marble floors common — extremely high slip risk, especially for patients in traditional dress (thobes, abayas).
Vision check: uncorrected visual impairment doubles falls risk. Refer to ophthalmology / optometry if not recently reviewed.
Medication review: psychotropics, antihypertensives, diuretics, hypoglycaemics all increase falls risk — structured deprescribing discussion
Footwear assessment: loose sandals (very common in GCC elderly) are a significant falls risk — advise proper footwear with non-slip soles
Hearing aids and glasses: ensure patient is using and can access sensory aids — sensory deprivation = falls risk

Deprescribing in Frailty

Deprescribing is the intentional dose reduction or discontinuation of medications that are no longer beneficial or may be harmful in the context of frailty.

STOPP criteria (high-yield for GCC exams): benzodiazepines, sedating antihistamines, anticholinergics, alpha-blockers causing orthostatic hypotension, NSAIDs in eGFR <50, long-term PPIs without indication, digoxin >125 mcg in eGFR <50
START criteria (omissions): ACEi/ARB post-MI if tolerated, statin if life expectancy >5 years, calcium + vitamin D if osteoporosis, metformin if type 2 DM tolerated
Nursing role: document patient-reported adverse drug effects, report to prescriber, complete discharge medication reconciliation, educate patient/family on which drugs have been stopped and why

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Community Physiotherapy: Home-based rehabilitation following acute illness is the most effective intervention to prevent re-hospitalisation in frail patients. Nurses can coordinate referral to community physio teams and monitor progress via telephone follow-up. In GCC: home nursing services are expanding — Saudi MOH Home Health Programme, Dubai Health Authority Home Care Unit.

CFS Scale 1–9 (Exam Format)

Very Fit

Robust, active, energetic, motivated and fit. Exercises regularly and is among the fittest for age group.

Well

No active disease symptoms but less fit than CFS 1. Exercises occasionally or only during seasonal activities.

Managing Well

Medical conditions are well controlled but not regularly active beyond routine walking. Pre-frailty zone.

Living with Very Mild Frailty

Not fully independent. Symptoms slow activity. May complain of being "slowed up" or tired during the day.

Living with Mild Frailty

More evidently slowed. Needs help with complex IADLs (finances, transport, housework, medications). Typically independent with basic ADLs.

Living with Moderate Frailty

Needs help with all outside activities and housekeeping. Indoors, has difficulty with stairs or needs help bathing. May require minimal assistance with basic ADLs.

Living with Severe Frailty

Completely dependent for personal care from whatever cause. Stable but not at high risk of dying within ~6 months.

Living with Very Severe Frailty

Completely dependent, approaching end of life. Small illnesses may precipitate death. Not terminally ill.

Terminally Ill

Approaching end of life. Life expectancy <6 months. This category applies even if otherwise not evidently frail.

Fried Frailty Phenotype — 5 Criteria (Exam Checklist)

W — Weight loss ≥4.5 kg or ≥5% in past year (unintentional)
E — Exhaustion / Fatigue (CES-D items 7 & 20)
A — Activity low (lowest quintile kcal/week by gender)
G — Gait speed slow (timed walk, adjusted for height/sex)
G — Grip strength weak (dynamometer, adjusted for BMI/sex)

0 = Robust | 1–2 = Pre-frail | 3–5 = Frail

Barthel Index — 10 Domains (Exam Table)

Domain	Max	Dependent Score
Feeding	10	0
Bathing	5	0
Grooming	5	0
Dressing	10	0
Bowel control	10	0
Bladder control	10	0
Toilet use	10	0
Transfers	15	0
Mobility	10	0
Stairs	10	0

0–20 Total dependence | 21–60 Severe | 61–90 Moderate | 91–99 Slight | 100 Independent

STOPP/START — Key Exam Points

STOPP = Screening Tool of Older Persons' Potentially inappropriate Prescriptions
START = Screening Tool to Alert doctors to the Right Treatment
STOPP identifies drugs to STOP; START identifies drugs being inappropriately omitted
High-yield STOPP drugs: benzodiazepines in falls, NSAIDs in eGFR<50, digoxin >125mcg in renal impairment, long-acting sulphonylureas (hypoglycaemia risk), anticholinergics, PPIs without indication >8 weeks
High-yield START omissions: ACEi/ARB post-MI, statins in CVD, calcium+VitD in osteoporosis, antidepressant if moderate/severe depression untreated
Beers Criteria (American Geriatrics Society) — US equivalent; used in some GCC hospitals with US-accreditation (JCI)

DHA / DOH / SCFHS / QCHP — High-Yield Frailty Topics

CFS 1–9 descriptions — expect pictorial or descriptive matching questions
Fried phenotype 5 criteria and scoring cutoffs (0=robust, 1-2=pre-frail, 3-5=frail)
Barthel Index domains and total score interpretation
MoCA vs MMSE — MoCA more sensitive for MCI; MoCA ≥26 = normal
STOPP/START principles and high-risk drug classes
Protein requirement in frail elderly: 1.2 g/kg/day minimum
Vitamin D supplementation threshold: supplement if <50 nmol/L
PINCH ME mnemonic for delirium causes
Prehabilitation concept for pre-operative frail patients
ACP trigger: CFS ≥5 warrants advance care planning discussion
DNACPR — legal, ethical, and cultural considerations in GCC
Hospital deconditioning: 10% muscle loss per week of bed rest in elderly

Frailty Assessment& Management

What is Frailty?

Frailty vs Related Concepts

5 Criteria (Fried et al. 2001 — CHS study)

Frailty Score Classification

Clinical Frailty Scale (CFS) — Rockwood

CGA Domains

Barthel Index (0–100) — ADL Assessment

Hospital-Acquired Deconditioning

HALO Framework — Hospital-Acquired Loss of function Opportunities

Nursing Mobility Protocol for Frail Patients

PINCH ME — Delirium Precipitants (Mnemonic)

Falls in Hospital — STRATIFY Tool

Frailty and Surgical Risk

Pre-operative Optimisation — "Prehabilitation"

Anaesthetic Considerations in Frailty

Primary Prevention of Frailty

Exercise Prescription for Frail Elderly

Multifactorial Falls Prevention Components

Deprescribing in Frailty

Very Fit

Well

Managing Well

Living with Very Mild Frailty

Living with Mild Frailty

Living with Moderate Frailty

Living with Severe Frailty

Living with Very Severe Frailty

Terminally Ill

Fried Frailty Phenotype — 5 Criteria (Exam Checklist)

Barthel Index — 10 Domains (Exam Table)

STOPP/START — Key Exam Points

DHA / DOH / SCFHS / QCHP — High-Yield Frailty Topics

Frailty Assessment
& Management