Review of Tools and Technologies to Assess Multi-System Functional Impairment and Frailty

The term ‘frailty’ has often been used—by clinicians and researchers alike—to characterize the most vulnerable and weak amongst the elderly. The treatment and care of this subgroup of older individuals presents the most challenge to clinicians and other health care professionals. Although there is no clear consensus on the issue of definition of frailty, most definitions emphasize the multi-system functional impairment and increased vulnerability to stressors. In order to intervene early and reverse or delay the decline in functional (physical and mental) capacity, it is of utmost importance to diagnose and objectively quantify the degree of functional deficit. This article aims to take an holistic approach by reviewing current and emerging tools and technologies available to assess multi-system functional impairment in older adults. Several widely-used indices of frailty, tests of physical function, and questionnaires to assess quality of daily life, nutritional status and mental and emotional functioning in older adults will be discussed in brief. Finally one emerging technology, accelerometry, which may enable the early diagnosis of loss of functional capacity as well as provide the ability to objectively quantify the degree of deficit in both clinical and non-clinical environments, will be described.