Chapter 1
Ferrucci (2004) (45) described eight indicators and potential outcome measures that are often used in trials (table 1.1) but there is no consensus on the classification of frailty or standardisation of outcome measures and hence conclusions about interventions are often difficult to draw. Cognitive indicators are recognised as important but there are methodological and ethical difficulties associated with measuring older people with dementia. That is not to say that older people with dementia should be excluded from interventions or research but careful consideration should be given that takes into account the cognitive factors. Whilst attempts have been made to improve clinical outcomes for frail people there are no interventions developed that specifically reverse the syndrome of frailty (46).
Table 1.1 Frailty indicators Indicator
Possible measure
Mobility
Gait speed.
Strength
Grip strength, chair rise, knee extensor strength.
Endurance
Lack of energy, tiredness, oxygen-uptake.
Nutrition
Under-nutrition, weight loss, body mass index, obesity.
Physical inactivity
Frequency and duration of walking and cycling in previous weeks and average amount of time spent monthly on hobbies, gardening, odd jobs and sport.
Balance
Items from Berg scale, sitting to standing, standing support, standing to sitting.
Motor processing
Coordination, movement planning and speed.
Cognition
Cognitive status measures.
Source: Ferrucci et al. A Consensus Report. J Am Geriatr Soc, 2004.
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