Frailty

The proportion of older people is continuously growing worldwide. This demographic phenomenon threatens the sustainability of our healthcare systems. The healthcare systems were initially designed for a population of patients (i.e., younger, with lower clinical complexity, and affected by acute conditions) utterly different from that referred today to the clinical and social services (i.e., much older, with high clinical complexity, and characterized by multiple chronic conditions). In this context, frailty (i.e., a geriatric condition defined by the age-related reduction of physiological reserves, exposing the individual to an increased vulnerability to exogenous and endogenous stressors) becomes of particular interest. Frailty introduces in the medical nomenclature a way for overcoming the traditional, but obsolete nosological constructs, shifting the clinician’s focus from the concept of “disease” to that of “function.” At the same time, it might provide a way for levering the entire healthcare system toward a more person-centered approach, stimulating multidisciplinary interactions and integration of services. In the present chapter, the concept of frailty is presented in its definition as well as in its clinical and public health relevance. Screening, assessment, and management methods are provided.