Frailty is increasingly recognized as a central concept in modern day care of the older person. Defined as a state of reduced physiological reserve and increased vulnerability to stressors, it is distinct from multimorbidity or disability. Contemporary approaches emphasize early identification through validated tools like the Fried frailty phenotype or the frailty index, ideally integrated into routine care or pre-treatment evaluations.
Frailty assessment is not simply a prognostic label. It guides clinical decisions, aligning care with client goals. Management focuses on increasing physiological and functional reserve via attention to physical activity and exercise, nutrition and total disease and medical risk management. This mitigates avoidable stressors such as falls and polypharmacy whilst simultaneously supporting functional independence.
Evidence supports interventions such as resistance training, protein supplementation and comprehensive geriatric assessment (CGA) to reduce frailty severity and improve outcomes. However, these benefits often fail to translate outside controlled research environments, indicating major challenges in implementation.
Care must be individualised along the frailty spectrum—from preventive strategies in robust adults to palliative approaches for those in end-stage frailty. Frailty should never be used to deny treatment, but rather to enable client-centred decisions. As populations age, integrating frailty-informed care into systems and workflows is essential to delivering effective, compassionate, and sustainable healthcare.
