Abstract
Stroke is predominantly a condition of older age. So, it seems sensible
that specialists working in stroke services should understand the primary
clinical syndrome of ageing—frailty. Recent studies have highlighted the
prevalence of frailty in stroke and its associated poor outcomes, yet
frailty does not feature prominently in stroke research, practice or policy.
Frailty-informed stroke care may differ from the interventional management
that dominates contemporary practice. However, this is not therapeutic
nihilism. A person-centred approach ensures that every care decision is
appropriate and based on a shared understanding of the person’s goals and
likely prognosis. We present a primer on frailty in stroke, describing
definition(s), epidemiology and prognostic implications. We discuss the
challenges surrounding assessment and management of frailty in stroke units
and offer practical guidance suitable for the stroke clinician.