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Screening for Frailty

Screening allows us to identify problems early and institute treatment or preventative strategies. Screening strategies will be developed for general practice and nursing homes in the first instance.

  • Screening Pathway Project 1 – Frailty Screening in General Practice

    Lead Investigator: Professor Justin Beilby

    Population ageing is proceeding at an unprecedented pace within Australia and worldwide.  Among the many manifestations of population ageing, frailty is arguably one of the most significant challenges facing health care providers and policy makers. The consequences of frailty have an enormous impact on the lived experience of older people.  As frailty progresses, there is evidence to show it has been linked with increased risks to older people’s independence and wellbeing, including poorer quality of life, increased health service usage, emergency department admission, institutionalisation and premature death.  Despite this fact, frailty remains somewhat of a hidden issue, with many frail older people not receiving the preventative care and attention they need until their condition is well advanced.

    Accordingly, a new wave of research has emerged that focuses on frailty prevention and management within primary health care and general practice settings.  It is widely acknowledged that general practitioners and their teams will be key in identifying and managing frailty. However, research into frailty within general practice populations remains at a relatively early stage, and there has been only minimal research conducted within Australia. As a consequence, our understanding of the mechanisms by which general practitioners can best address frailty progression, including how best to engage patients on the issue of frailty, remains extremely limited.

    Screening Pathway Project 1 will compare the performance of several internationally validated frailty screening tools across two South Australian general practice sites in the aim of selecting the best performing and most feasible tool for potential introduction within the Australian general practice setting.

    Media Contact: Ms Rachel Ambagtsheer

  • Screening Pathway Project 2 - Implementation Trial of Screening Tool

    Lead Investigator: Professor Justin Beilby

    Screening Pathway Project 2 will build on the results of Screening Pathway Project 1 in order to test the performance and feasibility of a well-performing frailty screening tool more broadly within a sample of 10 general practices across South Australia, spanning urban to rural and highly accessible to remote environments.

    In terms of assessing the tool’s performance with respect to predictive validity, a prospective random sample of 250 patients will be recruited across the practice sites and screened by a blinded researcher who will conduct a frailty assessment (assessing the performance of the instrument against the reference standards of the Frailty Phenotype and Frailty Index). Subjects will be followed up 12 months later to determine the ability of the tool to predict changes in physical function.

    A parallel project will employ a mixed-methods design to explore the feasibility of the tool with respect to its acceptability and feasibility for use within broader general practice. A number of screeners (general practitioners, practice nurses and non-specialists) will be recruited across the sites and will be surveyed pre- and post- implementation regarding their experiences of and attitudes towards using the tool.

    One of the key objectives of Screening Pathway Project 2 is to explore in what ways the preferred instrument could complement or be integrated with existing funded Medicare items such as the 75+ health assessments.  An intended outcome of the project is to determine what model for a potential frailty screening care pathway for general practice is suggested by the project’s findings.

    Media Contact: Ms Rachel Ambagtsheer

  • Screening For Frailty In Nursing Homes

    Lead Investigators: Professor Renuka Visvanathan, Dr Olga Theou, A/Prof Simon Bell, Professor John Morley and Professor Ken Rockwood

    There has been very little high quality research focused on frailty in nursing homes despite at least 85.2% of residents in one South Australian residential aged care organization (6 facilities) being classified as frail and 14.8% as at-risk. Members of our research team (TQEH geriatrics advanced trainee Dr Thanuja Jayaweera) supported by Dr Umapathysivam from the Joanna Briggs Institute are currently progressing a scoping review on frailty research in nursing homes.

    Until 2015, no frailty screening tool for use in residential aged care existed. Following a discussion between Professors Morley and Visvanathan in Adelaide at the Adelaide GTRAC Centre in late 2014, a frailty screening tool (FRAIL-NH) for use in nursing homes was developed and published in an international journal.

    Since that time point (early 2015), we have confirmed in Australia that a higher score on the FRAIL-NH which indicates greater risk of frailty was associated with higher care needs, poorer quality of life and increased nuero-psychiatric symptoms. Our team is currently investigating the ability of the FRAIL-NH to predict health outcomes such as mortality, falls and hospitalization.

    Professor Morley’s group in the United States of America have also confirmed that the FRAIL-NH was able to predict long-term outcomes such as 6 month mortality and falls.

    For some, frailty is treatable and quality of life can be improved. Therefore, screening for frailty even in residential aged care will support the identification of cost-effective strategies that may improve health and well-being of residents in residential aged care facilities (i.e. nursing homes).

    Media Contact: Professor Renuka Visvanathan or Dr Olga Theou

Centre of Research Excellence in
Frailty and Healthy Ageing
Address

THE UNIVERSITY OF ADELAIDE
SA 5005 AUSTRALIA

Contact

T: +61 8 8222 6140
F: +61 8 8222 7872
cre_frailty@adelaide.edu.au

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