Six key pillars of frailty prevention and management

Developed and endorsed by 77 healthcare experts and six consumers with lived experience, UQ researchers have published a national frailty framework.

Frailty — a complex clinical syndrome characterised by a decline in a person’s cognitive and physical function and a reduced ability to recover from stresses such as illnesses or injuries — can lead to falls, hospitalisation, worsening mobility and death and, it is estimated, impacts more than 20% of Australians aged over 65.

Now, a national frailty framework — the Australian Consensus Statements — has been developed as practical recommendations for clinicians. Published open access (doi: 10.5694/mja2.70182) in the Medical Journal of Australia and commissioned by the Queensland Health Reform Office in partnership with the University of Queensland’s (UQ) Australian Frailty Network, its recommendations were designed in consultation with Australian healthcare professionals, older adults with lived experience of frailty and caregivers.

“We have developed 19 consensus statements to guide frailty prevention and management and enhance quality of life for adults over 65 years,” said Dr Sakshi Chopra of UQ’s Frazer Institute. “Our aim is to reduce long-term complications, take pressure off the health system and offer practical recommendations to support healthcare professionals in delivering consistent and proactive care.

“By raising awareness and providing guidance to healthcare practices, we hope the framework will empower healthcare professionals and the public to recognise early signs and take action,” Chopra added. “We want to ensure people living with severe frailty continue to be valued and receive appropriate, person-centred care.”

The framework outlines practical recommendations for clinicians, including supporting adequate protein intake, structured exercise, meaningful social engagement, tailored care plans, raising awareness of frailty and personalised counselling on health behaviours.

Focusing on six key pillars — health promotion and screening, nutrition, exercise, social activities, medicine optimisation and management of severe frailty — Chopra said the pillars have been further categorised to support the management of mild, moderate and severe frailty, something, Chopra said, “that has not been attempted before”. “We want everyone to take a lifelong approach to frailty prevention, and these pillars can be applied to people of all ages,” Chopra said.

“In order to optimise the health and quality of life of older people, it is important for frailty to be prevented and, if it does occur, for it to be managed appropriately,” said geriatrician and Australian Frailty Network Director, Professor Ruth Hubbard.

“Evidence supports the effectiveness of multicomponent interventions, and our 19 consensus statements are guided by the six pillars to improve health outcomes for adults across the spectrum of health — from robust to severely frail.”

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