Improving Care for Older People in Hospital

Frailty and Delirium Dr Anne Hendry

National Clinical LeadScottish Government

Biological, Psychological,Social, societal modifiers/assets and deficits, Health and care systems

Frailty: a Complex Syndrome of Increased Vulnerability

Prevent/Delay FrailtyHealth Promotion and Prevention

Delay Onset

Delay/Prevent adverse outcomes, care

FRAILTY

Age

Life-courseDeterminants: Biological (including genetic)PsychologicalSocial, SocietalEnvironment

Chronic Disease

Decline in physiologic reserve

Adverse outcomes•Disability•Morbidity•Hospitalization• Institutionalization•Death

Candidate markers

• Nutrition• Mobility• Activity• Strength• Endurance• Cognition• Mood

Modified from Bergman H, 2008

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(JAGS 2008; 56: 2171-9)

Basal IMPAIRED

1 month

Basal IMPAIRED

3 months

Basal IMPAIRED

6 months

Basal IMPAIRED

12 months

DURING THE LAST TWO DECADESWE HAVE BUILT STRONG EVIDENCE

Frailty Tool

Examples

• North Staffs• Lanarkshire • Fife • Tayside

• Bournemoth- N Staffs / Lanarkshire hybrid