Frailty Predicts Outcomes Better than Age

People are frequently reminded that the most vulnerable populations likely to become seriously ill from the novel coronavirus are older adults over the age of 65 and people with underlying health conditions like diabetes, heart disease, or asthma. However, a recent European study found that frailty better predicted disease outcomes for adult patients admitted to hospital with confirmed coronavirus infections. 

According to a recent article published online in The Lancet Public Health, an observational study of 1,564 adult patients diagnosed with COVID-19 found that frailty, characterized by “diminished strength, endurance and reduced physiologic function” better predicted the outcomes of patients than age.  Although it is more likely to become frail in older age, it can also occur among younger adults, especially those who have had surgery or required intensive care. Clinical Frailty Scores (CFS) of patients admitted to intensive care units are routinely collected as recommended by the National Health Service.  

Patients with a CFS ranging from mildly frail to very severely frail was associated with both a longer time spent in hospital and an earlier death than patients who rated as very fit or fit. Patients with high frailty scores are more likely to require longer to recover and rehabilitate, as well as a more complex discharge plan. 

The finding of the study help guide clinical decisions concerning the treatment of COVID-19 patients based on their frailty status.   The CFS data is a quick assessment tool, best performed by a geriatrician.  Study authors agree, however that frailty alone should not be used to inform clinical decisions. 

For older adults, the study findings are one more reason to keep active and fit.  While we wait for promising vaccines and treatments to undergo proper testing, protecting our well-being with regular exercise, a healthy diet, and stress management along with hand washing and wearing a mask in public is our best bet to avoid life-threatening illness.