COVID-19 Prevention: Use of Self-Reported Tools to Screen Frail Older Adults

Abstract

Dear Editor Identifying the co-existing frailty is of great importance in the COVID-19 pandemic (1). Older age, high number of comorbidities, and inflammatory markers i.e., C-reactive protein, D-dimer, and procalcitonin were associated with severity or progression of COVID-19 (2, 3). All of these studies indicate that older adults are at high risk of developing COVID-19 because of frailty and the aging immune system. Frailty is an emerging global health burden, with major implications for clinical practice and public health. Frailty refers to a geriatric syndrome that increases an individual’s vulnerability to degenerative changes and chronic diseases (4). It is most widely defined as an age-related biological syndrome characterized by the reduced function of several physiological systems. This degeneration decreases physiological reserves and increases the vulnerability to endogenous or exogenous shock. The syndrome has deep biological underpinnings and is related to aging and disability. Older individuals with this syndrome are more likely to have a higher risk of decreased physiological functions, worsened chronic diseases, and death. In other words, they have a higher chance of becoming seriously and life-threateningly ill than those with good health, implying they face the highest risk of COVID-19. Thus, to lessen the burden of mortality, reducing the risk of infection in this group is mandatory. COVID-19 will affect long-term care and older adults. Interventions against this disease, therefore, should be targeted for the most vulnerable groups, especially the elderly and frail individuals. The identification of frailty can help predict adverse clinical outcomes (e.g., disability, hospitalization, and death), patient recovery, and the risk of complications from acute illness or stress. In the first step, quick and validated self-reported frailty tools such as such as the FRAIL and frailty screening questionnaires (FSQ), which are easy-to-use frailty tools to predict worse outcomes in both community and emergency settings (5, 6), should be used to identify frailty among older adults. The mortality of COVID-19 is also correlated with its health-care burden. Therefore, preventive measures should be taken to reduce the risk of death due to this disease, e.g., early detection of frail older adults at risk of COVID-19. The elderly should also be encouraged to adopt precautions against the virus, such as washing hands frequently, checking body temperature daily, wearing masks, keeping their hands away from their faces, staying away from people with signs of illness, and maintaining close contact with local health officials and strong social support. These measures are essential for protecting the frail older adults and mitigating the severity of patient outcomes.