Frailty, although a recognisable and common phenomenon in ageing, is difficult to accurately define and diagnose. It is a multi-factorial condition, influenced by the combination of a person’s physical, psychological and social health. As a result, any approach to understanding frailty needs to be holistic and must take account of a broad range of factors. The selection and design of the TRIL assessment is optimised to produce detailed information across a wide range of these bio–psycho–social elements, and provides an invaluable resource to inform our research in to the characterization of frailty.
A frailty index has been created using data collected during the first phase of TRIL. This index has been based on the work of Linda Fried (Fried et al. 2001). She characterized frailty as a syndrome in which three or more of the following criteria are present:
• unintentional weight loss
• self-reported exhaustion
• weakness (as measured by grip strength)
• slow walking speed
• low physical activity
Another well established and accepted marker of frailty is the occurrence of falls. Falls continue to be a central focus of TRIL research with more than one third of people over the age of 65 having at least one fall each year. Falls have significant adverse impacts on older people and are a major cost to healthcare systems worldwide. After a fall, older patients often voluntarily restrict their activity because they fear a reoccurrence. This reduction in exercise leads to further weakness that, in turn, increases the risk of another fall — a vicious cycle. In addition to this, current intervention strategies only result in a 30% reduction in the reoccurrence of falls after one year. Therefore the focus of our work is to elucidate the factors contributing to falls and to use this information to develop assessment tools to identify those at risk of falls. Appropriate intervention therapies and technologies may then be developed to assist older people in the management of falls risk and the prevention of future falls.