Geriatric Syndrome

Frailty Interventions: Evidence-Based Outpatient Care

Frailty is a clinical syndrome of decreased physiologic reserve and increased vulnerability to stressors — affecting 10–25% of community-dwelling adults over 65 and more than half of those over 85. Identifying frailty changes management: it predicts adverse surgical outcomes, hospitalization, falls, and mortality, and it should reframe goals of care, medication choices, and screening intensity. This guide uses the Clinical Frailty Scale (CFS) for rapid bedside assessment and the Fried frailty phenotype (weight loss, exhaustion, weakness, slow gait, low activity) for research-grade evaluation. Evidence-based interventions include resistance and balance exercise (the single highest-impact intervention), protein-targeted nutrition (1.0–1.2 g/kg/day), vitamin D repletion, polypharmacy reduction with deprescribing tools, and early goals-of-care conversations. Includes guidance on when to refer to a geriatrician, PT for structured exercise, or palliative care.

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