Should we screen for frailty in primary care settings? A fresh perspective on the frailty evidence base: A narrative review

• Published in: Preventive medicine Vol. 119; pp. 63 - 69
• Main Authors: Ambagtsheer, Rachel C., Beilby, Justin J., Visvanathan, Renuka, Dent, Elsa, Yu, Solomon, Braunack-Mayer, Annette J.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2019
• Subjects: Aged; Aged, 80 and over; Family practice; Frailty; Frailty - psychology; General practice; Geriatric Assessment; Health Policy; Humans; Independent Living; Mass Screening; Primary health care; Primary Health Care - statistics & numerical data; Geriatric assessment; Primary health care; Aged, 80 and over; Frailty; General practice; Aged; Mass screening; Family practice
• ISSN: 0091-7435; 1096-0260; 1096-0260
• DOI: 10.1016/j.ypmed.2018.12.020

With older adults living longer, health service providers have increasingly turned their attention towards frailty and its significant consequences for health and well-being. Consequently, frailty screening has gained momentum as a possible health policy answer to the question of what can be done to prevent frailty's onset and progression. However, who should be screened for frailty, where and when remains a subject of extensive debate. The purpose of this narrative review is to explore the dimensions of this question with reference to Wilson and Jungner's time-tested and widely accepted principles for acceptable screening within community settings. Although the balance of the emerging evidence to support frailty screening is promising, significant gaps in the evidence base remain. Consequently, when assessed against Wilson and Jungner's principles, extensive population screening does not appear to be supported by the evidence. However, screening for the purpose of case-finding may prove useful among older adults. •Frailty is highly prevalent among older people and has serious consequences.•Emerging evidence suggests frailty is reversible but needs early identification.•Debate continues over whether the evidence base justifies systematic screening.•Practitioners and policy-makers need objective criteria to assess the evidence.•The evidence base is currently insufficient to support systematic screening of all older adults.