Frailty in older people

Key points about frailty

  • Frailty is a common problem for older people and is considered a long-term condition.
  • Frailty can be caused by a health problem and can cause more health problems.
  • If you are an older adult with frailty, you are at higher risk of other health problems in the event of stress or illness.
  • The key to managing frailty is early recognition and careful planning.
  • Frailty can't be reversed but there are things you can do to help prevent its progression.
Older women walking outside, one with walker
Print this page

In common language, frailty means 'weak and vulnerable'. In older adults, frailty refers to the loss of physical, cognitive or social ability to recover from illnesses or stressful events. If you are frail, even a minor change, such as being prescribed a new medicine or a minor infection, can cause a dramatic change to your state of health. 

Frailty is not defined by old age. While frailty is more common in older adults, just because you are older doesn't mean you will be frail. Older people with frailty are often more resilient to health challenges than people who have frailty at a younger age. 

The diagnosis is important because if have frailty, you are at higher risk of other health problems if you have a stressful event or an illness. This may affect the decision made by your healthcare providers in regard to investigations or treatment of your condition. 

Older people with frailty are at higher risk of:

  • falls
  • immobility
  • incontinence
  • confusion
  • being admitted to hospital and long hospital stays
  • requiring nursing care
  • side effects for new medicines
  • major change in health state due to a minor problem such as a mild infection.

Frailty can be caused by a health problem and can cause more health problems. For example, a fall in an older adult can affect muscle strength and mobility, causing frailty. On the other hand, if an older adult is frail, he or she is more susceptible to falls. 

Common risk factors of frailty include:

Because there is no one factor that makes a person frail, frailty is, in essence, a clinical diagnosis. This means there are no specific tests. Your doctor makes a diagnosis by taking into account the overall interaction of many factors, including health conditions, weight and physical function.

They will consider:

  • your walking speed and physical activity status
  • your grip strength
  • whether you need help with daily activities such as household chores
  • your weight and body mass index (BMI).

There are a number of different scores and questionnaires developed and used all over the world to help health professionals diagnose frailty, but there isn’t a standard one used in New Zealand. Examples of these include the Rockwood Clinical Frailty Score(external link)(external link) and the Edmonton Frail Scale(external link)(external link)

The key to managing frailty is early recognition and careful planning. This can help avoid some of the impacts of frailty when your healthcare providers make decisions about your health.

Some of the things your healthcare providers may do include:

  • reviewing your medicines regularly and remove unnecessary medicines to avoid potential harms of one or more medicines (polypharmacy)
  • conducting regular checks of your health status, including your physical and mental health 
  • assessing and providing specific needs for care and support 
  • reviewing your home circumstances to reduce risk factors that can cause falls
  • discussing with you about having an advanced care plan in the event of illness or falls
  • supporting healthy lifestyle choices.

Unfortunately, frailty can't be reversed but there are measures to help prevent its progression. These include the following:

Below are some support services and information designed to meet the needs of older people. 

Read more about services for older people

The following links provide further information about frailty. Be aware that websites from other countries may have information that differs from NZ recommendations.

Live stronger for longer(external link)(external link), NZ 
Frailty and multimorbidity(external link)(external link) Patient Info, UK 
Frailty(external link)(external link) NHS, UK


Sample meal plan for frail older people  [PDF, 102 KB]Ministry of Health, NZ, 2013
Physical activity for older people (65+)(external link) (external link)Ministry of Health, NZ, 2013


  1. Defining and recognising frailty(external link)(external link) Health Quality & Safety Commission, NZ, 2019
  2. Health and frailty assessment for older adults(external link)(external link) Auckland Regional HealthPathways, NZ, 2019
  3. Frailty in older people – a discussion(external link)(external link) BPAC, NZ, 2018

Clinical resources and guidelines

The HQSC frailty care guides(external link) HQSC, NZ, 2023 are a suite of 26 nursing decision support tools covering the spectrum of frailty from deterioration to communication and advance treatment planning.

Other resources

Frailty in older people – a discussion(external link) BPAC, NZ, 2018
Management of multimorbidity(external link) Ministry of Health, NZ, 2019

Continuing professional development

Maximising the health of older people – Goodfellow MedTalk(external link) (Goodfellow MedTalks, NZ, 2018)
Dr Helen Fulcher, Goodfellow GP advisor, talks with University of Auckland Head of School of Population Health and general practitioner Professor Ngaire Kerse about maximising the health of older patients.

Optimisation of care of older patients(external link) Podcast Goodfellow NZ, 2018
Lucy Fergus talks about optimisation of care in older patients. Lucy is a geriatrician and medical director for older person’s health, rehabilitation and allied services at Hawkes Bay Hospital.

The impact of frailty on prescribing medication – Goodfellow webinar(external link) 
Dr Chris Cameron, a general physician and clinical pharmacologist in Wellington, discusses what defines frailty and why this is important to assess in older patients. Frailty can be used as a starting point to review and withdraw medicines, as it can give us an indication of the length of life left.


meal plan
Sample meal plan for frail older people

Ministry of Health, NZ, 2013

physical activity for older people 65 plus
Physical activity for older people (65+)

Ministry of Health, NZ, 2013

Need help now?

Healthline logo in supporters block

Need to talk logo

Healthpoint logo

Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Dr Helen Kenealy, geriatrician and general physician, Counties Manukau DHB

Last reviewed:

Page last updated: