The frailty syndrome in the public health agenda

A PubMed search of articles in this journal using the text word ‘frailty’ found only two manuscripts, published in 2010 and 2012.1 ,2 Thus, many readers of the journal may not be familiar with the concept and public health implications of the frailty syndrome.3 ,4 This is notable for several reasons. First, because frailty is a frequent condition, with a prevalence of about 10% in the population over age 60 years, reaching 25% in those aged 80 years and older.5 ,6 Also, in a well-known prospective study among community-dwelling older persons, the most common condition leading to death was frailty (27.9%), followed by organ failure (21.4%), cancer (19.3%) and dementia (13.8%).7 Additionally, frailty shows an important social gradient, so that women and less educated persons are more likely to be frail and to have an increased risk of worsening frailty status.3 ,4 ,8 Second, because the process of frailty can potentially be prevented and treated.4 This is important because frailty is a strong risk factor for mobility loss, falls, dependence, institutionalisation and death after exposure to even minor stressors.3 ,4 Moreover, frailty is a recognised predictor of outcomes after medical and surgical interventions, and should be taken into account before prescribing them to older patients.9 Given the accelerated ageing of the population in most countries, and the expected increase in the number of individuals with disability and dependence, interventions on frailty may be a good avenue to prevent or delay disability, which is a major cause of usage of healthcare and social services. And finally, because in 2003 the Institute of Medicine identified frailty as 1 of 20 priority areas, selected from several hundred candidates, in need of improvements in healthcare quality.10 Moreover, the European …