What screening tools are recommended for the identification of frailty in older adults in primary care?

The primary recommended screening tool for identifying frailty in older adults within primary care settings is the Electronic Frailty Index (eFI) ². The eFI may be used to identify individuals aged 65 years and over who may be living with moderate or severe frailty ². This recommendation is based on updated guidance from NHS England ².

While not specifically frailty screening tools, gait and balance assessments are crucial in identifying older adults at risk of falls, a common manifestation of frailty ². The Timed Up & Go test and the Turn 180° test are pragmatic tools that can be used in any setting and require no special equipment ². The Timed Up & Go test involves timing a person getting up from a chair, walking 3 metres, turning, returning, and sitting down, with a score of 12–15 seconds or more potentially indicating a high risk of falls ². The Turn 180° test assesses if a person takes more than four steps to turn around, which may warrant further assessment ². These tests are useful for predicting the risk of falling in community-dwelling older people ². Broader assessment tools exist for various biopsychosocial dimensions of frailty (De Luca et al., 2022), and sarcopenia, a component of physical frailty, also has specific assessment and management approaches (Beaudart et al., 2016).

It is important to note that general falls risk prediction tools should not be used to predict a person's risk of falling ⁴. Comprehensive falls assessments, which include identifying frailty, are offered to people who have fallen in the last year and meet specific criteria, such as living with frailty, sustaining an injury, or having recurrent falls ⁴.