From the Guidelines
Dr. Kenneth Rockwood is a renowned Canadian physician and researcher who has made significant contributions to the field of geriatric medicine, particularly in the study of frailty in older adults, as evident from his work published in leading journals such as Nature Aging 1 and Ageing Research Reviews 1. His development of the Clinical Frailty Scale, a widely used tool for assessing an elderly patient's level of frailty on a 9-point scale, has been instrumental in determining appropriate care plans and predicting outcomes for older patients. The concept of frailty that Rockwood helped develop recognizes that aging affects people differently, and that biological age often matters more than chronological age when making medical decisions, which is supported by recent studies on frailty identification, management, and prevention 1. Some key findings from recent studies include the importance of simple frailty screening instruments, the use of artificial intelligence to identify individuals with frailty, and the effectiveness of strength-based training in combating frailty 1. Overall, Dr. Rockwood's work has been instrumental in shifting the medical community's understanding of aging from a focus solely on chronological age to a more comprehensive view that considers overall health status and vulnerability, and his research continues to influence geriatric care practices worldwide, emphasizing the importance of personalized approaches to treating elderly patients 1. Some of the key areas of focus in recent studies on frailty include:
- Identification: simple frailty screening instruments, artificial intelligence-based assessment, and novel biomarkers for frailty 1
- Management: strength-based training, exercise modes, and multidimensional interventions 1
- Risk Factors and Prevention: lifestyle factors, genetics, co-morbidities, and environmental factors 1
- Future treatments: emerging treatments such as complementary therapy, mesenchymal stem cell and stromal cell therapy, and myokines and denervation 1
From the Research
Kenneth Rockwood and Frailty Research
- Kenneth Rockwood is a prominent researcher in the field of frailty, with numerous studies focusing on the development and application of the Clinical Frailty Scale (CFS) 2, 3, 4.
- The CFS is a judgement-based frailty tool that evaluates specific domains, including comorbidity, function, and cognition, to generate a frailty score ranging from 1 (very fit) to 9 (terminally ill) 3.
- Research has shown that the CFS is a useful predictor of mortality and other clinical outcomes in older adults, including unplanned hospital admissions and falls 4.
Clinical Frailty Scale Applications
- The CFS has been widely used in multiple settings, including geriatric wards and hospitals, to assess frailty and predict clinical outcomes 3.
- The scale has been updated to version 2.0, with revised level names and minor edits to level descriptions, to improve its usability and accuracy 2.
- The CFS requires clinical judgement and is not widely validated in younger people or those with stable single-system disabilities 2.
Frailty Management and Identification
- Frailty is a geriatric syndrome that affects 5% to 17% of older adults, characterized by increased vulnerability across multiple health domains, leading to adverse health outcomes 5.
- A comprehensive geriatric assessment can identify risk factors and symptoms that suggest frailty, and several validated frailty assessment tools can evaluate a patient for frailty 5.
- The management of frail patients must be individualized and tailored to each patient's goals of care and life expectancy, with physical activity and balance exercises suitable for less frail patients, and palliative care and symptom control appropriate for more frail patients 5, 6.