What is it about?
This article discusses how frailty in older adults should be addressed in clinical care. Instead of trying to define frailty as one fixed condition, the authors suggest using it as a signal for when to apply a Comprehensive Geriatric Assessment (CGA). Frailty screening (using simple tools) can identify those at risk, and then CGA—an in-depth evaluation of health, function, and social needs—can guide care planning. The article highlights the need for internationally harmonized guidelines to standardize how frailty screening leads to CGA, ensuring consistency across different settings and cultures.
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Why is it important?
Frailty is complex: It reflects not just physical weakness but also cognitive, psychological, and social factors. Global relevance: Different countries view and manage frailty differently, which makes it hard to create universal definitions. Practical impact: Without a shared framework, outcomes from CGA vary widely, limiting its usefulness for patients, healthcare providers, and policymakers. Example from Japan: The new Japanese CGA-based Healthcare Guidelines (2024) demonstrate how frailty screening can be systematically linked to CGA, interdisciplinary care planning, and meaningful outcomes such as maintaining independence and reducing caregiver burden.
Perspectives
Holistic view: Frailty should not be fragmented into narrow categories (like “oral frailty” or “social frailty”), but seen as a multidimensional concept. Stepwise approach: Start with simple frailty screening, and then apply CGA only when needed, making the process more efficient. Flexibility: Guidelines should be adaptable to different healthcare systems, available resources, and cultural contexts. Future direction: Harmonized CGA frameworks can improve care for older adults worldwide, advance research, and shape policy. Biological insights: Understanding the links between frailty and conditions like sarcopenia may further refine how CGA is applied.
Prof Takuya Omura
National Center for Geriatrics and Gerontology
Read the Original
This page is a summary of: Global Framework for Comprehensive Geriatric Assessment Implementation Following Frailty Screening, Journal of the American Medical Directors Association, August 2025, Elsevier,
DOI: 10.1016/j.jamda.2025.105801.
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