Using consensus methods to prioritize modifiable risk factors for development of manifestations of frailty in hospitalized older adults.
Susanne Coleman, Faye Wray, Kristian Hudson and 15 others
PMID 36161707WHAT IT FOUND
14 clinical and academic experts agreed 44 modifiable risk factors for frailty in hospitalized older adults, from pain and medication to mobility, elimination and call bells.
This is a care planning list, not tested evidence that targeting them improves outcomes.
Key findings
0114 clinical and academic experts agreed 44 modifiable risk factors for inclusion in a novel system of care for hospitalized older adults.
02The agreed mobility-related factors included prolonged bedrest, lack of correct walking aid, inadequate footwear, drips, lines and monitors, and not having a mobility and functional assessment in a timely manner.
03Low BMI, sarcopenia, poor balance and poor external support were considered not modifiable within a 5 to 7 day acute admission.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study involved 14 expert clinicians and researchers, not patients, so it reports expert agreement rather than patient outcomes. It did not test whether targeting the agreed risk factors reduces frailty, falls, delirium or functional decline. The small panel raises questions about reliability and whether it represents wider clinical views. Some factors were dropped or deprioritized because they were not considered modifiable within a 5 to 7 day acute admission or were organizational.
Declared interests
Independent research funded by the National Institute for Health Research. Authors declared no conflict of interest.
The easy way to misread this
Do not treat the 44 agreed risk factors as evidence that a frailty care bundle works. The paper only reports expert consensus on which factors should be targeted; no patient outcomes were measured.