What assessment tools are recommended for evaluating frailty in older adults in primary care?

In primary care settings, the recommended approach to evaluating frailty in older adults involves using comprehensive, multidimensional assessment tools that capture physical, cognitive, and psychosocial domains. UK guidelines emphasize identifying frailty through clinical judgment supported by structured assessments, often integrated within broader falls risk and multimorbidity evaluations. Specifically, the NICE guideline on falls and multimorbidity recommends assessing gait, balance, mobility, muscle strength, cognitive function, and psychosocial factors as part of a multifactorial assessment to identify frailty and related risks ¹,².

Validated frailty screening tools suitable for primary care include the Clinical Frailty Scale (CFS), which provides a rapid clinical judgment-based frailty categorization, and the electronic Frailty Index (eFI), which utilises routine primary care data to stratify frailty severity. These tools align with NICE’s emphasis on identifying frailty to guide comprehensive falls assessment and management ¹,².

Recent literature further supports a biopsychosocial approach to frailty assessment, recommending tools that evaluate physical performance (e.g., gait speed, grip strength), cognitive status, nutritional status, and psychosocial dimensions such as mood and social support (De Luca et al., 2022). Sarcopenia assessment tools, including muscle mass and function measures, are also integral to frailty evaluation, as muscle weakness is a core component of frailty (Beaudart et al., 2016). This comprehensive approach complements the UK guidelines’ multifactorial assessment framework ¹,²[(De Luca et al., 2022)][(Beaudart et al., 2016)].

In summary, primary care practitioners should use validated frailty screening tools like the CFS or eFI combined with targeted assessments of physical function, cognition, and psychosocial factors to evaluate frailty in older adults. This approach enables identification of those at risk who may benefit from tailored interventions to prevent falls and functional decline, consistent with NICE recommendations and supported by recent evidence (Beaudart et al., 2016; De Luca et al., 2022) ¹,²[(Beaudart et al., 2016)][(De Luca et al., 2022)].