Frailty in Acute Care Settings

Frailty in acute care settings is common and associated with poor outcomes. Older adults with frailty often present with geriatric syndromes as a manifestation of their acute illness. There are many assessment tools to assess frailty in hospitalized older patients. Based on the current evidence, only the frailty index (FI) has shown good feasibility, validity, and reliability. However, other tools with good supporting evidence include the clinical frailty scale (CFS), the claims-based frailty index (FI), a FI based on laboratory tests and vital signs (FI-LAB), and the FRAIL Scale. Evidence is emerging that tailored interprofessional interventions-including comprehensive geriatric assessment, exercise, deprescribing, and nutritional assistance-may improve clinical outcomes. We will review the benefits of multicomponent exercise programs such as ViviFrail and REHAB-HF, deprescribing, and nutritional assistance. More randomized clinical trials are needed to further address the applicability of the above frailty assessment tools and recommended interventions in diverse acute care settings.