Frailty Impacts Felt Across Western Sydney
Increased visits of older people into General Practices are continuing to highlight the importance of early prevention and timely intervention of Frailty. A commonly held misconception of frailty is that it is a normal part of ageing.
Frailty affects up to one in four people aged 70 and over, increasing the risk of falls, functional decline, hospitalisation and reduced quality of life. Frailty continues to be under recognised and is now viewed as a chronic condition which occurs due to a combination of deconditioning and acute illness on a background of existing functional decline.
Importantly, Frailty can be reversed. Early detection and timely intervention can help older adults stay active, independent, and at home for longer.
To help support general practices and practice teams across Western Sydney, WentWest has launched the Healthy Ageing Frailty Early Intervention Program —a practical, evidence‑based approach to help embed frailty screening into everyday care.
Facilitated by primary care experts, Dr Chris Bollen and Jane Bollen, the program is a limited opportunity for 20 general practices in Western Sydney and is filling fast.
What Exactly is Frailty?
Frailty occurs when gradual loss of strength, endurance and physiological reserve makes a person more vulnerable to illness and decline. People living with frailty have 2–3 times higher health‑care use and often experience poorer outcomes.
It commonly presents through one or more geriatric syndromes, including:
- Cognitive decline
- Falls or low‑trauma fractures
- Impaired or deteriorating gait
- Chronic urinary incontinence
- Multiple co‑existing medical conditions (particularly in adults over 85)
- Polypharmacy and susceptibility to medication‑related adverse effects
Importantly, the risk of developing frailty increases progressively with age and adults over 50 begin to experience the early vulnerabilities associated with this trajectory.
How do you Recognise Frailty?
It is important to be familiar with new evidence-based frailty screening tools as it is no longer acceptable to respond by demeaning the older person with unhelpful comments such as “there’s nothing much to be done” or “it’s because you are getting older”.
Evidence based responses now show:
- Referrals for resistance exercise (muscle building) programs
- Dietary supplementation (Vitamin D and protein enriched meals such as sustagen and whey protein)
- Social and cognitive stimulation and support
Can in combination slow both the rate of functional decline and frequently reverse decline if people are detected at the early frail stage.
Current recommendations support routine frailty screening for people aged 70+, using validated tools such as the FRAIL Scale to ensure accurate, consistent identification of pre‑frailty and frailty.
Other practice-based tips which are worth adding to consults/care plans/health assessments for anyone over 75 are doing 5 timed sit-to-stands and to weigh older people at every consultation.
What to do if Frailty is Found
If the older person scores 1-2 on the FRAIL screen, they are pre-frail, and 3+ indicates they are frail and would benefit with:
- Referral for a community based restorative care program such as coordinated by MyAgedcare (noting the FRAIL score in the referral) using the HealthLink smart form in GP software
- Home Medication review by a consultant pharmacist or a Medication review by the GP or a Geriatrician, in order to consider deprescribing medications which may be slowing people down
- A home-based exercise program such as provided by a home visiting exercise physiologist service (many available using web search)
- Online exercise programs for older people
Helpful Resources for Frailty
Frailty is a complex issue and to better help your thinking for new ways to tackle the complex issue there are a few helpful resources:
- Video links to updates on 75+ health assessments, and identifying frailty in General Practice
- Meat and Livestock brochure available to give to patients about protein and its importance when older and tips for living well after age 65
- Podcasts: Stronger Through The Ages, Frailty- Management tips for general practice and The Healthy Ageing Podcast
- This BBC/ABC program discusses the issues of how to reduce the effects of ageing
- Western Sydney HealthPathways also has information on deprescribing as well as managing older people and weight loss
You can also still register for the Healthy Ageing Frailty Early Intervention Program. Spots are strictly limited and filling up fast.
This article was written with support from Dr Chris Bollen, FRACGP, Director of Bollen Health