New frailty index to improve aged care outcomes

A new frailty index is set to improve aged care and health outcomes for vulnerable older people.

The frailty index project, developed and validated by SAHMRI-based Registry of Senior Australians (ROSA) and Flinders University Research Fellow Dr Jyoti Khadka, has the ability to measure frailty at a population level, especially when it is a pivotal time for older Australians.

It should deliver broad benefits across the aged care sector, says Dr Khadka, from the Flinders Caring Futures Institute.

“This index can accurately predict an individual’s risk of death and the likelihood that they might need long-term residential aged care,” Dr Khadka says.

“This is extremely important information because frailty can be treated or prevented. Identifying risk enables timely treatment through relatively simple means such as diet and physical and mental exercises.”

Flinders University Research Fellow Dr Jyoti Khadka.

In medical terms, frailty is defined as a state of increased weakness and vulnerability to adverse health outcomes including falls, injuries, dependency, hospitalisation, institutionalisation and death.

Fellow research team member Professor Renuka Visvanathan, an internationally recognised expert in geriatric medicine, says use of the index can be incorporated into the more than 186,000 aged care eligibility assessments currently performed each year by an aged care assessment team (ACAT).

“The assessment of a person’s frailty at this important time in their aged care journey can be used to flag those who might benefit from additional support to lower their risk of adverse events like hospitalisation,” she says.

“There is increasing interest for assessment programs which use electronic systems such as our Australian aged care eligibility assessments, which is supported by My Aged Care. This can produce a frailty risk score by the end of an assessment with the older person.”

Dr Khadka says the frailty index is already proving highly valuable from a research perspective across several ROSA projects.

“For instance, a study recently published in the journal Bone used the index to demonstrate how frailty changes the risk of death, functional limitation and higher level of aged care following a hip fracture,” he says.

The frailty index was developed using historical data involving more than 900,000 older Australians. The process behind its development was published in the Medical Journal of Australia.

Development and validation of a frailty index based on Australian Aged Care Assessment Program data by Jyoti Khadka, Renuka Visvanathan, Olga Theou, Max Moldovan, Azmeraw T Amare, Catherine Lang, Julie Ratcliffe, Steven L Wesselingh and Maria C Inacio can be viewed online in the Medical Journal of Australia DOI: 10.5694/mja2.50720

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Caring Futures Institute College of Nursing and Health Sciences