Internal and Emergency Medicine

, Volume 14, Issue 1, pp 5–6 | Cite as

Why and how do we measure frailty?

  • Matteo CesariEmail author

In the present issue of Internal and Emergency Medicine, Gullón et al. [1] report the results of an interesting observational study aimed at evaluating the prescription patterns of anticoagulants in a sample of older persons with non-valvular atrial fibrillation. In particular, the authors are interested in exploring the influence that the frailty condition (defined using the FRAIL scale [2]) may have on the therapeutic choices. The study confirms that frailty is highly prevalent in the hospital setting, and clearly represents a risk condition for negative health-related outcomes (in particular, in-hospital and 1-year mortality). Nevertheless, it seems that frailty does not represent a predictor of anticoagulant prescription, whereas functional impairment (captured by the Barthel Index) does.

The article raises important points worth a discussion. The present results are consistent with a large body of evidence documenting the association of frailty with negative health-related...


Compliance with ethical standards

Conflict of interest

The author declares that he has no conflict of interest.

Statement of human and animal rights

The article does not contain any study on human participants or animals.

Informed consent

Informed consent was not required.


  1. 1.
    Gullón A, Formiga F, Dìez-Manglano J et al (2018) Influence of frailty on anticoaugulant prescription and clinical outcomes after 1-year follow-up in hospitalised older patients with atrial fibrillation. Intern Emerg Med. CrossRefPubMedGoogle Scholar
  2. 2.
    Abellan van Kan G, Rolland YM, Morley JE, Vellas B (2008) Frailty: toward a clinical definition. J Am Med Dir Assoc 9:71–72CrossRefPubMedGoogle Scholar
  3. 3.
    Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K (2013) Frailty in elderly people. Lancet 381:752–762CrossRefPubMedGoogle Scholar
  4. 4.
    Cesari M, Prince M, Thiyagarajan JA et al (2016) Frailty: an emerging public health priority. J Am Med Dir Assoc 17:188–192CrossRefPubMedGoogle Scholar
  5. 5.
    Cesari M, Marzetti E, Thiem U et al (2016) The geriatric management of frailty as paradigm of “The end of the disease era”. Eur J Intern Med 31:11–14CrossRefPubMedGoogle Scholar
  6. 6.
    Balducci L, Colloca G, Cesari M, Gambassi G (2010) Assessment and treatment of elderly patients with cancer. Surg Oncol 19:117–123CrossRefPubMedGoogle Scholar
  7. 7.
    Walston J, Robinson TN, Zieman S et al (2017) Integrating frailty research into the medical specialties—report from a U13 conference. J Am Geriatr Soc 65:2134–2139CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Aguayo GA, Donneau AF, Vaillant MT et al (2017) Agreement between 35 published frailty scores in the general population. Am J Epidemiol 186(4):420–434. CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Abellan Van Kan G, Rolland Y, Bergman H, Morley JE, Kritchevsky SB, Vellas B (2008) The I.A.N.A Task Force on frailty assessment of older people in clinical practice. J Nutr Health Aging 12:29–37CrossRefPubMedGoogle Scholar
  10. 10.
    Morley JE, Little MO, Berg-Weger M (2017) Rapid geriatric assessment: a tool for primary care physicians. J Am Med Dir Assoc 18:195–199CrossRefPubMedGoogle Scholar
  11. 11.
    Searle SD, Rockwood K (2018) What proportion of older adults in hospital are frail? Lancet 391:1751–1752CrossRefPubMedGoogle Scholar

Copyright information

© Società Italiana di Medicina Interna 2018

Authors and Affiliations

  1. 1.Department of Clinical Sciences and Community HealthUniversity of MilanMilanItaly
  2. 2.Geriatric UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly

Personalised recommendations