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It is well known that frailty alone is associated with a limited prognosis and that the degree of frailty correlates with life expectancy. However, this understanding is seldom used in clinical practice. The important features of frailty, including impairments in mobility, functional status, cognition and social support, are undervalued as prognostic indicators, and without a careful history, the trajectory of decline may not be apparent. Instead, the patient’s story is lost and he becomes a collection of medical diagnoses, where each diagnosis is treated without regard for the overall picture. As a result, patients are subjected to needless and often risky investigations and treatments. Without identifying frailty, we are unlikely to recognize when our patients are nearing the end of life.
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