Monitoring frailty using technology

Frailty is a major problem in our healthcare system. The population of the developed world is ageing. Most older people are healthy, living an active life, but a substantial number becomes frail. Frailty is the result of a gradual decrease of bodily reserves. When these reserves reach a critical point even a small incident – an illness or a fall – can lead to serious complications, like disability, new falls, emergency hospital admission, loss of independence, and even death. About 11% of people aged over 65 are frail and another 42% is at risk of becoming frail. Frailty is costly to both the individual and to healthcare sectors. As an example, falls are highly associated with frailty, and in the UK falls alone are estimated to cost the NHS in excess of £2.3 billion each year.

There is no real treatment for frailty. Frail people often come to the attention of services at a stage of acute need or sudden decline. In these situations it is difficult to reverse the condition. That is why it is of utmost importance to find ways to prevent decline. In the UK older people are screened for frailty or risk of becoming frail by general practitioners. A tool for frailty identification now widely used in the UK is the electronic Frailty Index (eFI). The eFI uses codes from the primary care electronic health record to identify and grade people for frailty. If ‘flagged’ by the eFI the general practitioner can invite the person for an examination. This active screening method is a first step towards a proactive and preventative approach. However, if health crises are to be avoided, a more sensitive and precise monitoring system needs to be developed. That is the purpose of this project: to develop a set of simple yet accurate tools that people can use to quickly and regularly measure indicators of physical frailty in their own homes, and that gives them (and their caregivers) feedback about their physical status and changes thereof.