Frailty in a person with developmental disability

People with developmental disability are vulnerable to frailty, and it should be considered at a younger age than in the general population.

The frail person is at increased risk of disability and death from minor external stresses (eg mild infection, minor injury). Frailty affects the person’s quality of life and may lead to falls, more frequent and lengthy hospitalisations, and the need for greater intensity of care in high-support facilities. Early identification, intervention and rehabilitation in frailty may help to prevent or delay adverse outcomes.

Ask about features of frailty including weight loss, muscle mass loss (sarcopenia) and weakness, easy fatigability and reduced mobility or ability to carry out usual activities. Frailty can coexist in people who are obese. Pre-existing disability can make assessment and diagnosis of frailty more complex. Primary care assessment tools (eg those listed in the Royal Australian College of General Practitioners RACGP aged care clinical guide [Silver Book]) may be useful in those with mild disability. There are frailty measures for use in people with developmental disability, which take into account pre-existing disability and do not rely on the person understanding instructions for testing muscle strength or gait¹.

There is good evidence that targeted physical activity with resistance training, improved nutrition and reducing polypharmacy are effective strategies to manage frailty. See also Falls prevention in people with developmental disability.