title: Screening for Frailty in Canada's Health Care System: A Time for Action.
abstract: As Canada's population ages, frailty - with its increased risk of functional decline, deterioration in health status, and death - will become increasingly common. The physiology of frailty reflects its multisystem, multi-organ origins. About a quarter of Canadians over age 65 are frail, increasing to over half in those older than 85. Our health care system is organized around single-organ systems, impairing our ability to effectively treat people having multiple disorders and functional limitations. To address frailty, we must recognize when it occurs, increase awareness of its significance, develop holistic models of care, and generate better evidence for its treatment. Recognizing how frailty impacts lifespan will allow for integration of care goals into treatment options. Different settings in the Canadian health care system will require different strategies and tools to assess frailty. Given the magnitude of challenges frailty poses for the health care system as currently organized, policy changes will be essential.
authors.affiliation: Department of Medicine,Queens University.
authors.forename: John
authors.initials: J
authors.lastname: Muscedere
authors.affiliation: Division of Geriatric Medicine,Dalhousie University.
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Andrew
authors.affiliation: Division of Critical Care Medicine,University of Alberta.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Bagshaw
authors.affiliation: Faculty of Nursing,University of Alberta.
authors.forename: Carole
authors.initials: C
authors.lastname: Estabrooks
authors.affiliation: Cumming School of Medicine,University of Calgary.
authors.forename: David
authors.initials: D
authors.lastname: Hogan
authors.affiliation: Departments of Medicine and Community Health Sciences,University of Calgary.
authors.forename: Jayna
authors.initials: J
authors.lastname: Holroyd-Leduc
authors.affiliation: Pharmacology and Medicine (Geriatric Medicine),Dalhousie University.
authors.forename: Susan
authors.initials: S
authors.lastname: Howlett
authors.affiliation: Schulich School of Law and the School of Health Administration,Dalhousie University.
authors.forename: William
authors.initials: W
authors.lastname: Lahey
authors.affiliation: Schools of Pharmacy and Public Health & Health Systems,University of Waterloo.
authors.forename: Colleen
authors.initials: C
authors.lastname: Maxwell
authors.affiliation: Faculties of Dentistry and Medicine,Dalhousie University.
authors.forename: Mary
authors.initials: M
authors.lastname: McNally
authors.affiliation: Division of Geriatric Medicine,Dalhousie University.
authors.forename: Paige
authors.initials: P
authors.lastname: Moorhouse
authors.affiliation: Division of Geriatric Medicine,Dalhousie University.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Rockwood
authors.affiliation: Department of Medicine,University of Alberta.
authors.forename: Darryl
authors.initials: D
authors.lastname: Rolfson
authors.affiliation: Department of Medicine and Family and Community Medicine and the Institute of Health Policy,Management and Evaluation,University of Toronto.
authors.forename: Samir
authors.initials: S
authors.lastname: Sinha
authors.affiliation: President and CEO of HealthCareCAN,Ottawa.
authors.forename: Bill
authors.initials: B
authors.lastname: Tholl
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D040561:Assisted Living Facilities; D002170:Canada; D003422:Critical Care; D003695:Delivery of Health Care; D016330:Frail Elderly; D006291:Health Policy; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D008403:Mass Screening; D009735:Nursing Homes; D011320:Primary Health Care; D057170:Translational Research, Biomedical
keywords: aging; assessment; de dépistage; fragilité; frailty; health care system; outcomes; résultats; screening; système de santé; vieillissement; évaluation