# Care and Health Needs of Older Patients with Frailty in General Practice

## TL;DR

The study examines the care needs and health of older patients with frailty in a primary care setting in Poland, finding that frailty is common and linked to higher care needs and more frequent healthcare visits.

## Contribution

This study provides insights into the prevalence of frailty and associated care needs in a high-risk older patient cohort in general practice.

## Key findings

- Frailty (CFS ≥ 5) was observed in 26% of the high-risk cohort, while vulnerability (CFS 4) was observed in 48%.
- Frailer patients required more assistance and had significantly higher primary care utilization compared to non-frail individuals.
- Patients with higher CFS scores had more frequent primary care visits, with frail patients averaging 17 visits per year.

## Abstract

Background/Objectives: Frailty is a major geriatric syndrome encountered in general practice. This study described the distribution of Clinical Frailty Scale (CFS) categories, care needs, and primary care utilization in a Vulnerable Elders Survey (VES-13)- screened high-risk cohort (VES-13 ≥ 3) from a single general practice. These prevalence estimates apply to this high-risk, single-centre primary care sample and should not be interpreted as estimates for unselected older primary care populations. Methods: We retrospectively reviewed medical records of 150 patients aged ≥ 60 years from a single primary care practice in Warsaw, Poland (1 August 2022–1 August 2023), restricted to those with VES-13 scores ≥ 3 (a routinely screened, high-risk subgroup). Frailty was assessed using the CFS. Results: The mean age of participants was 77 ± 8 years, and men accounted for 28% of the sample. Within this VES-13-selected high-risk cohort, 39 individuals (26%) were classified as non-frail (CFS 1–3), 72 (48%) as vulnerable (CFS 4), and 39 (26%) as frail (CFS ≥ 5). The need for assistance increased markedly with frailty severity, affecting 13% of non-frail individuals, 78% of vulnerable participants, and 100% of frail patients (p < 0.001). In the CFS ≥ 5 group, 46% required help several times per day and 8% required 24 h care. Patients with higher CFS scores used primary health care (PHC) services more frequently (mean 10 ± 5 visits per year in the non-frail group vs. 12 ± 6 in the vulnerable group and 17 ± 10 in the frail group; p < 0.001). Conclusions: In this single-practice, VES-13-selected high-risk primary care cohort, frailty (CFS ≥ 5) was observed in approximately one in four patients and vulnerability (CFS 4) in approximately one in two. Greater CFS severity was associated with higher care needs and more frequent primary care utilization.