Frailty: different tools for different purposes?

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Abstract
In this issue, Ravaglia et al. [ 1 ], report on ‘a frailty score’, which they have tested as a predictor of a range of adverse health outcomes which they characterise as ‘frailty outcomes’ in people aged 65+ years (mean age at baseline was 74.7) [ 1 ]. The outcomes were death (14.6% of the baseline sample), fractures, hospitalisation, and new onset or worsening of capacity to perform activities of daily living (ADL) during the next 4 years. Their model was arrived at through statistical exploration of data from a longitudinal population study of 1,016 individuals in Italy. The nine variables emerging after multivariate analysis were age >80 years, male gender, low physical activity, co-morbidity, sensory deficits, calf circumference <31 cm (taken as an indicator of sarcopenia), dependence in Instrumental ADL, a Tinetti gait and balance performance score ≤24, and pessimism about one's health compared to others. Together they produce a numerical score which at various cut-points tested was significantly predictive of the ‘frailty outcomes’. While acknowledging that their prognostic score is not yet adequately developed and requires at least to be tested in a remote cohort of older people, the authors suggest that their findings support further investigation of frailty scores for use in clinical geriatric practice.

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