Fit
CFS SCORE: 3 and less
KEY INTERVENTION: Healthy Ageing
| Involve
Enhance the voice of older people, carers and families to tackle the frailty challenge together at a community and individual level.
Visit the Frailty icare website for more on ‘Involve’
| Consider
Always think frailty! An awareness of the modifiable risk factors for frailty and understanding signs of pre-frailty can help with early appropriate lifestyle interventions.
Social Class
The prevalence of frailty is significantly more common in those with low income compared to high income. For example, 7% in households income over 60,000 versus 32.4% in households on less than 20,000. BMC family practice. David R. Lee
Education
The prevalence of frailty is significantly more common in those with low levels of education compared to high levels.
The prevalence of frailty is significantly more common in those with low level of education compared to high levels. For example, 10.8% in college graduates versus 33.4% in those not graduating from high school. BMC family practice. David R. Lee
Alcohol Intake
Moderate alcohol consumption may have a protective effect on developing frailty whereas people who have high consumption in midlife have a likely risk of developing frailty and pre-frailty by 1.6 and 1.4 times more than people not drinking alcohol.
Diet
An increasing adherence to the Mediterranean Diet was associated with decreasing risk of frailty.
Smoking
Smoking is a predictor of worsening frailty status in community-dwelling population. Smoking cessation may potentially be beneficial for preventing or reversing frailty.
Occupation
There is a significant relationship between frailty risk and life-course occupations in advanced age (e.g. intrinsically harder, manual or blue-collar employment).
Obesity
The prevalence of frailty is significantly higher is those who are obese. For example, 32.7% versus 22.8% respectively.
Deprivation
There is a strong link between socioeconomic deprivation and multimorbidity: multimorbidity occurs 10–15 years earlier in people living in the most deprived areas than it does in those living in the most affluent areas.
Visit the Frailty icare website for more on ‘Consider’
| Assess
If there are any signs of pre-frailty or frailty, patients should be assessed using the Clinical Frailty Scale for verification and classification of their level of frailty.
Visit the Frailty icare website for more on ‘Assess’
| Respond
Healthy ageing and caring approaches with signposting to keeping active, engaged and independent, including access to frailty-friendly living and homes.
What Works?
Look after your feet, mouth & teeth
Get moving - including aerobic, resistance, balance and flexibility training
Stop smoking
Eat well - consider nutritional supplements (e.g. vitamin D)
Drink alcohol sensibly
Get a hearing and eye test
Keep an active mind
Sleep well
Keep safe at home & keep warm
Get vaccinated
Visit the Frailty icare website for more on ‘Respond’
| Evaluate
To see if you are making a difference, whether at an individual level or within your local area or system, consider the following…
The benefit for individuals
Measuring what you’re doing
The impact on populations, communities and services
Benefits
Provide health benefits
A protective effect into retirement
Increase physical activity, reduce long-term exhaustion and improve energy intake
Prevent frailty progression
Prevent fractures (for vitamin D and calcium supplementation)
Reduce hospital admissions and mortality
Impact
In Sunderland almost 7,000 additional people are likely to become frail that could be prevented by reducing their alcohol intake.
Across the ICS, obesity means that 7,560 people will become frail that could have been prevented.
Visit the Frailty icare website for more on ‘Evaluate’
+ Resources
Healthier for Longer: How healthcare professionals can support older people (British Geriatrics Society)
Managing Frailty at an Individual Level: A Systematic Review (ADVANTAGE Managing Frailty)
Living Well in Communities with Frailty: Evidence for what works (NHS Scotland)
Visit the ‘Respond - Healthy Ageing and Caring’ section on the Frailty iCARE website for more useful resources.
