de Tornyay Center for Healthy Aging

April 12, 2022

Top Cited Article: Thai Frailty Scale

Former de Tornyay Scholar Inthira Roopsawang’s paper “The Reported Edmonton Frail Scale-Thai version: Development and Validation of a Culturally-Sensitive Instrument”, in Nursing & Health Science was listed as one of the journal’s top-cited articles!

Want to learn more about the research? Find Roopsawang’s paper here and find the center’s article on her work and frailty below, originally published in the local newspaper NW Primetime in 2019. 

Frailty across Cultures

While some see frailty as a natural consequence of aging, the reality is much more complicated than that. Frailty is a set of symptoms that come with aging muscles and bones, but this process is much faster in some individuals than others – so many older adults are not considered frail.

Typically someone is considered frail if they have three out of five classic symptoms: walking slowly, weak grip, exhaustion, low physical activity and unintentional weight loss. Frailty increases individuals’ risks of disabilities and other health concerns, such as falling and complications after surgery, so it’s important that health care providers can identify and address it.

Inthira Roopsawang, a graduate student at the UW School of Nursing, received the de Tornyay Center for Healthy Aging’s PhD Pathways to Health Aging award for her research in frailty. She became interested in the topic after working as an orthopedic nurse in rural Thailand and seeing many frail older adults come in and out of the hospital. But the hospital had no way of identifying who was at higher risk for surgical complications because of frailty.

“Why did older peoples who have the same surgery procedure, age, gender, and health conditions present different outcomes after surgery?” Inthira wondered. After digging deeper, she found that frailty seemed to be the answer. “However, the knowledge of frailty is new in some areas, including Thailand.”

There are several ways to measure and identify frailty for English speakers, but none in Thai. Roopsawang set out to translate a measurement tool for frailty to the Thai language and culture that health care workers could use in the clinic to identify frailty. She purposely used a survey that didn’t take a lot of training to administer or time to complete, so that it would be realistic to implement in rural settings with less resources.

From initial testing, her translated tool appears to work. She successfully used it to identify individuals with frailty who were at a greater risk for longer hospital stays and complications after surgery in Thailand. As the first way to measure frailty in Thai, this tool could open up new opportunities for Thai frailty research, help compare frailty across cultures, and improve treatment for Thai older adults who are frail.

By understanding and identifying patients who are frail, health care providers can modify treatment to reduce patients’ risk, especially for any surgeries. They can also work with patients to combat their symptoms through lifestyle changes.

Habits such as getting regular exercise, can reduce frailty, as well as eating a healthy diet. Recent research led by UW School of Nursing professor Dr. Oleg Zaslavsky found that the Mediterranean diet, which is rich in vegetables, nuts and whole grains reduced the risk of death in older women with frailty.

“The burden of frailty will impact the health of all older adults globally,” said Inthira. “Gaining more understanding of frailty is the key to provide better care and promote health.”