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Treatment of Diabetes in Older Patients

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Assessment 8 Table 4. Tools to Detect Frailty Assessment Tool Comments Fried Score Well-established physical frailty tool based on data from the Cardiovascular Health Study; oen seen as a reference frame for studies of frailty in community- dwelling older adults; requires 2 procedures/measures (gait speed and grip strength) and answers to 3 questions (relating to weight loss, level of exhaustion, and amount of physical activity); can identify 'prefrail' individuals (Fried LP, Tangen CM et al. Frailty in older adults: Evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001; 56(3): M146- 156). Clinical Frailty Scale Note: A larger 70-item assessment tool called the Frailty Index is also available. Based on data from the Canadian Study of Health & Aging ; 7-point scale; predictive of future events including mortality; easy to employ in routine clinical practice (Rockwood K, Song X et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005; 173(5): 489-495). FRAIL score Well-validated in multiple population groups; sensitivity and specificity similar to that of the Fried scale. Comprises only 5 questions (no procedures) covering fatigue, climbing stairs, walking, number of illnesses, and weight loss (Abellan van Kan G, Rolland Y et al. e I.A.N.A Task Force on frailty assessment of older people in clinical practice. J Nutr Health Aging 2008; 12(1): 29-37). Source: Sinclair AJ, Abdelhafiz A, Dunning T, Izquierdo M, Rodriguez Manas L, Bourdel- Marchasson I, Morley JE, Munshi M, Woo J, Vellas B. An international position statement on the management of frailty in diabetes mellitus: summary of recommendations 2017. J Frailty Aging 2018; 7:10-20.

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