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• W2340806006 abstract "It is encouraging that recognition of frailty as a key element of the care of older people is entering the discourse of emergency medicine, as discussed by Elsa Dent and colleagues in their letter to The Lancet (Jan 30, p 434).1Dent E Hoogendijk EO Cardona-Morrell M Hillman K Frailty in emergency departments.Lancet. 2016; 387: 434Summary Full Text Full Text PDF PubMed Scopus (16) Google Scholar Older patients (aged 65 years or older) not only represent an increasing proportion of patients presenting acutely to emergency departments, but are also the group most likely to present with care needs appropriate to emergency care.2Burns E Older people in accident and emergency departments.Age Ageing. 2001; 30: 3-6Crossref PubMed Scopus (528) Google Scholar Although Dent and colleagues have correctly identified the need for better assessment tools, technological support, and guidelines for the detection and management of frailty,1Dent E Hoogendijk EO Cardona-Morrell M Hillman K Frailty in emergency departments.Lancet. 2016; 387: 434Summary Full Text Full Text PDF PubMed Scopus (16) Google Scholar an element that is missing from their proposal is geriatric expertise. The principles and practice of geriatric nursing and geriatric medicine are at the heart of the effectiveness of age-attuned medicine and supporting patients affected by frailty.3Ellis G Whitehead MA O'Neill D Langhorne P Robinson D Comprehensive geriatric assessment for older adults admitted to hospital.Cochrane Database Syst Rev. 2011; 7 (CD006211.)PubMed Google Scholar Not only is there a need to include specialist expertise in pathways of assessment and care in emergency departments,4Conroy SP Ansari K Williams M et al.A controlled evaluation of comprehensive geriatric assessment in the emergency department: the ‘Emergency Frailty Unit’.Age Ageing. 2014; 43: 109-114Crossref PubMed Scopus (117) Google Scholar but there is also a need to ensure that gerontology and geriatric medicine form a core part of training for all staff working in emergency departments. This notion is supported by research indicating that trainee doctors who have had training in geriatric medicine are more likely to be able to manage key elements of frailty management, such as assessment of cognitive function.5Kennelly SP Morley D Coughlan T Collins R Rochford M O'Neill D Knowledge, skills and attitudes of doctors towards assessing cognition in older patients in the emergency department.Postgrad Med J. 2013; 89: 137-141Crossref PubMed Scopus (32) Google Scholar Targeting poor gerontological knowledge must be a central element to ensure that frail, older patients in emergency departments receive care adequate to their needs. We declare no competing interests. Frailty in emergency departmentsPopulation ageing is placing a heavy demand on health-care systems worldwide. This pressure is being particularly felt by hospital emergency departments, which are facing an unprecedented influx of older patients (65 years and older).1 Of concern, more than half of these older patients are likely to be frail.2 Frailty signifies an increased vulnerability to external stressors and has been purported to be the largest global problem associated with an ageing population.3 Full-Text PDF" @default.
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• W2340806006 title "Frailty in emergency departments" @default.
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• W2340806006 doi "https://doi.org/10.1016/s0140-6736(16)30273-2" @default.
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