Diagnosis and management of frailty

Abstract

Background: Frailty, a syndrome characterized by reduced physiological reserve and heightened susceptibility to stressors, impairs homeostasis across physical, psychological, and physiological domains in older adults. Approximately 50% of older Korean adults are frail or pre-frail, which highlights the need for targeted interventions in community healthcare and primary care settings.Current Concepts: Various methods, including use of physical and biological markers and health deficit analysis are available for frailty assessment; the Frailty Phenotype and Frailty Index are widely used screening tools. Following advances in technology, electronic health records and big data play a key role in identifying potential biomarkers. Considering the multifaceted nature of frailty, comprehensive geriatric assessments are recommended for holistic evaluation and management, based on a patient’s medical, psychological, and functional capabilities. Effective management can reverse frailty, which emphasizes the importance of early detection and multidisciplinary interventions. International and national guidelines propose a comprehensive approach focusing on modifiable risk factors, physical activity, a balanced diet, chronic disease management, social participation, and regular review of medication regimens. Personalized care plans based on comprehensive assessments are essential to enhance or maintain the residual function of frail older adults to improve their quality of life and reduce the need for long-term care.Discussion and Conclusion: Timely and effective management of potentially reversible frailty highlights the importance of prompt detection and a multidisciplinary approach to care. International and national guidelines recommend a holistic management strategy. Tailored care plans based on comprehensive geriatric assessments are pivotal in improving or maintaining the functional capabilities of frail elderly individuals to enhance their quality of life.