Moving Evidence into Practice..with Technology
• Frailty is sometimes overlooked, as screening for it is not a part of standard medical care.
• Using technology like smartphone/tablet apps could make it easier and more efficient to assess frailty.
• The Fit-Frailty Assessment & Management (FFAM) App is a simple electronic tool that helps to identify individuals at risk of frailty and sarcopenia (loss of skeletal muscle mass and strength).
• Results will provide valuable information to help guide medical teams in developing treatment plans.
Co-Design Approach: The project team worked with patients, families, and front-line clinicians to learn more about their experiences using this new technology and test it in healthcare settings.
Overview: The Fit-Frailty Assessment and Management App was developed at the GERAS Centre for Aging Research at Hamilton Health Sciences (affiliated with McMaster University) by Drs. Courtney Kennedy, George Ioannidis, Alexandra Papaioannou, Jonathan (Rick) Adachi in partnership with Dr. Kenneth Rockwood and the Geriatric Medicine Research Group at Dalhousie University. It is a comprehensive measure of frailty* that incorporates disease-related, physical, cognitive, psychosocial, and functional aspects. It was designed to help save time in busy clinical settings and be easily completed by older adults and caregivers. The full, interactive assessment is completed in-person and includes physical performance measures which can identify individuals at risk of sarcopenia in addition to frailty. A telephone/videoconference version has also been validated that is entirely self-reported and uses proxies for physical performance measures.
Based on Dr. Kenneth Rockwood’s Frailty Index approach, which considers frailty as a multi-dimensional state that exists on a continuum of severity.*
*(1) Searle SD, Mitnitski A, Gahbauer EA, Gill TM, Rockwood K. A standard procedure for creating a frailty index. BMC Geriatr. 2008 Sep 30;8:24. (2) Jones DM, Song X, Rockwood K. Operationalizing a frailty index from a standardized comprehensive geriatric assessment. J Am Geriatr Soc. 2004 Nov;52(11):1929-33. (3) Kennedy CC, Ioannidis G, Rockwood K, Thabane L, Adachi JD, Kirkland S, Pickard LE, Papaioannou A. A Frailty Index predicts 10-year fracture risk in adults age 25 years and older: results from the Canadian Multicentre Osteoporosis Study (CaMos). Osteoporos Int. 2014 Dec;25(12):2825-32.
Available for download at:
coming soon to the App store (www.apple.com/ca/app-store/)
App Developed by:
• Courtney Kennedy, OT, PhD
• George Ioannidis, PhD
• Alexandra Papaioannou, BScN, MD, MSc
• Jonathan Adachi, MD
• Kenneth Rockwood, MD
(in alphabetical order)
Pauline Fisher, MN
Alicia Hanman, BSc
Patricia Hewston, OT, PhD
Justin Lee, MD, PhD
Sharon Marr, MD
Caitlin McArthur, PT, PhD
Ahmed Negm, MD, PhD
Sarah Park, MD
Aastha Relan (BHSc student)
Olga Theou, PhD
Sigrid Vinson, RN, CCRA
Tricia Woo, MD
Clinical Validation Study
Hamilton Health Sciences, Centre for Healthy Aging
Brian Misiaszek, MD
Alexandra Papaioannou, MD
Christopher Patterson, MD
Mona Sidhu, MD
Richard Sztramko, MD
Mimi Wang, MD
Tricia Woo, MD
CREATE (CentRE for dAta science and digiTal hEalth) team at Hamilton Health Sciences
*Adapted from a Frailty Index (Rockwood Cumulative Deficits method) validated in the population-based Canadian Multicentre Osteoporosis Study (CaMOS study).