Frailty: identification and assessment

Frailty is a group of symptoms rather than a single disease. It has biological, psychological, and social dimensions.

This means it is important for clinicians to accurately identify and assess each individual’s level of frailty, and determine what care and support they need.

On this page you’ll find tools and resources to help.

How to identify frailty

It is rare that people see themselves as ‘frail’. Instead, they might describe ‘slowing down’ or modifying activities to meet their physical ability.

When you are identifying and assessing frailty, you should avoid reinforcing negative stereotypes of aging and dependency. Focus on what each person can do and what support they need to live well.

Enabling people to live well with frailty requires you to understand each individual, what support networks they already have and what is important to them. It is important to optimise quantity and quality of life.

Carrying out a holistic assessment will help you determine what person-centred care is appropriate.

The nature of frailty means that all individual assessments should be part of an ongoing cycle, not a standalone activity.

'Frailty syndromes' or 'acute presentations'

’Frailty syndromes’, or ‘acute presentations’, are:

falls
sudden reduced mobility
new or accelerated state of confusion (delirium)
acute change in continence
sensitivity to a new medication.

These should be regarded as ‘red flags’ for frailty, as they often mean a sudden change in the individual’s physical health function and mental capacity.

Electronic Frailty Index (eFI) uses routinely collected data from primary care electronic record systems, to identify biological, psychosocial, and social deficits and assess the frailty prevalence in a population.
This is vital for health and social care strategy planning and can help you identify who in your local population may be frail.
However, it cannot be directly applied to an individual.