The territorial community hospital of Lorraine is composed by the University Hospital of Nancy and the Regional Hospital of Metz (the “sillon Lorrain” hospital). 2012 key figures of the university hospital of Nancy are the following: 1664 in-patient hospital beds and 68487 in-patient hospitalizations for an average stay of 7,1 days; 175 801 medical outpatient consultations. The Geriatric Department of the University Hospital of Nancy includes extremely competent physicians who are very involved in the life of the establishment with a view to offer to elderly patients the highest quality of care in a modern and warm environment and participating also in teaching, research and information. The Nancy group, affiliated to the INSERM Unit UMR S1116, is involved for many years in the evaluation and the management of old frail patients. This thematic is actually one of the main scopes of the Federation Hospitalo-Universitaire (FHU) on cardiac and arterial aging CARTAGE ( the Nancy group coordinates.

In the context of the project, the Nancy team will contribute to the definition and detailed evaluation of the markers of frailty and the development of instruments that would be useful in various clinical settings. The generally accepted definition of frailty, “A biological syndrome of decreased reserve and resistance to stressors, resulting from cumulative declines across multiple physiologic systems and causing vulnerability to adverse outcomes” mirrors the definition of aging, although chronological age is only one factor that predicts a vulnerability to frailty. Susceptibility to stressors also is influenced by biological, behavioural, environmental, and social risk factors, with the main consequence being an increased risk for multiple adverse health outcomes, including disability, morbidity, falls, hospitalization, institutionalization, and death. Our understanding of frailty has markedly improved over the last five years, yet there are many issues yet to be resolved. The challenge is now to develop a research strategy that would move the field forward within the next few years by defining frailty markers and developing instruments that would be useful in various clinical settings. Ultimately, these tools will be most relevant if they accompany effective health promotion, prevention, treatment, rehabilitation, and care interventions. Presently, a number of clinical studies show that detection of frailty may predict probability of events such as mortality, major morbidity, length of hospitalizations and loss of autonomy but also can define the benefit/risk ratio of therapeutic interventions much better than the chronological age. Nancy group will focus on proposing assessment tools that can be administered quickly and easily by general practitioners, nurses, pharmacists, home health providers, social workers, and other health care workers. A positive screen would indicate the need for more detailed evaluation of the markers of frailty to enable tailoring of interventions to the patient.

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