Reversing Frailty Levels in Primary Care Using the CARES Model

Olga Theou; Grace H Park; Antonina Garm; Xiaowei Song; Barry Clarke; Kenneth Rockwood

doi:10.5770/cgj.20.274

Reversing Frailty Levels in Primary Care Using the CARES Model

Can Geriatr J. 2017 Sep 28;20(3):105-111. doi: 10.5770/cgj.20.274. eCollection 2017 Sep.

Authors

Olga Theou¹, Grace H Park², Antonina Garm², Xiaowei Song², Barry Clarke³, Kenneth Rockwood¹

Affiliations

¹ Department of Geriatric Medicine, Dalhousie University and Nova Scotia Health Authority, Halifax, NS.
² Fraser Health Authority, Surrey, BC.
³ Department of Family Medicine, Dalhousie University and Nova Scotia Health Authority, Halifax, NS.

Abstract

Background: The purpose of this manuscript was to evaluate the effectiveness of the Community Actions and Resources Empowering Seniors (CARES) model in measuring and mitigating frailty among community-dwelling older adults.

Methods: The CARES model is based on a goal-oriented multidisciplinary primary care plan which combines a comprehensive geriatric assessment (CGA) with health coaching. A total of 51 older adults (82 ± 7 years; 33 females) participated in the pilot phase of this initiative. Frailty was measured using the Clinical Frailty Scale (CFS) and the Frailty Index (FI-CGA) at baseline and at six-month follow-up.

Results: The FI-CGA at follow-up (0.21 ± 0.08) was significantly lower than the FI-CGA at baseline (0.24 ± 0.08), suggesting an average reduction of 1.8 deficits. Sixty-one per cent of participants improved their FI-CGA and 38% improved CFS categories. Participants classified as vulnerable/frail at baseline were more responsive to the intervention compared to non-frail participants.

Conclusion: Pilot data showed that it is feasible to assess frailty in primary care and that the CARES intervention might have a positive effect on frailty, a promising finding that requires further investigations. General practitioners who participate in the CARES model can now access their patients' FI-CGA scores at point of service through their electronic medical records.

Keywords: Community Actions and Resources Empowering Seniors (CARES); clinical frailty scale; comprehensive geriatric assessment; frailty; frailty index.