​Frailty in older adults is associated with a multitude of adverse events, such as falls, weight loss, and functional decline and can lead to risky hospitalizations and even death. Writing in the September/October 2018 issue of Annals of Long-Term Care, researchers describe a frailty scale they developed to help staff identify residents most at risk of experiencing an adverse event. The authors quote an earlier study showing that "77% of older adults who were hospitalized as a result of a collapse or fall and who had a discharge diagnosis of an 'ill-defined condition' were characterized as having frailty." Frailty is assessed through the evaluation of physical attributes such as weight, weakness, exhaustion, gait speed, level of physical activity, need for support devices, walking ability, and continence. Researchers developed the tool, called the "interRAI Nursing Home (NH) Frailty Scale," using data from 1,097,189 U.S. nursing home residents in 2012 as baseline and from 1,007,450 residents at a 90-day follow-up. Researchers then reviewed all assessments at the 120-day mark. The 21-item scale represents outcome measures in function, cognition and communication, medical diagnosis, clinical status, and treatment. Scoring ranges from 0 (no frailty) to 14, with a median of 4. In the cohort in which the tool was tested, older adults with a score of 6 or higher were at increased risk of death related to frailty; those with lower scores had lower distress rates for each measure. Other results pointed to associations between physical frailty or ability, cognitive decline, weight loss, and adverse outcomes. The authors suggest the tool can influence decisions related to long-term care planning, medication reviews, and development of advanced directives.