CMAJ • January 31, 2006; 174 (3). doi:10.1503/cmaj.1050249.
© 2006 CMA Media Inc. or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
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Letters

Measuring frailty in geriatric patients

Kenneth Rockwood*, Chris MacKnight* and Howard Bergman{dagger}

*Division of Geriatric Medicine, Dalhousie University, Halifax, NS; {dagger}Division of Geriatric Medicine, McGill University, Montréal, Que.

[The authors respond:]

In his comments on our article,1 Doug Duke usefully reminds us that the care of elderly people is complex and commonly requires a multidisciplinary approach. He cautions that, if we use tools to assign patients to a frailty category, "expediency might override fairness." This is, of course, a concern. However, older people who are reasonably fit derive little additional benefit from complex, multidisciplinary care compared with usual care, whereas elderly people who are frail benefit greatly.2,3,4 A pragmatic, nonarbitrary way is thus needed to classify relative degrees of fitness and frailty. In addition to being useful for research purposes, the scale we described aims to meet this need.

REFERENCES

  1. Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005;173(5):489-95.[Abstract/Free Full Text]
  2. Maly RC, Hirsch SH, Reuben DH. The performance of simple instruments in detecting geriatric conditions and selecting community-dwelling older people for geriatric assessment. Age Ageing 1997;26:223-31.[Abstract/Free Full Text]
  3. Rockwood K, Stadnyk K, Carver D, et al. A clinimetric evaluation of specialized geriatric care for rural dwelling, frail older people. J Am Geriatr Soc 2000;48:1080-5.[Medline]
  4. Gill TM, Baker DI, Gottschalk M, et al. A program to prevent functional decline in physically frail, elderly persons who live at home. N Engl J Med 2002;347:1068-74.[Abstract/Free Full Text]




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