Knowledge to Practice Series: Frailty Conversations - Intrinsic Capacity Matters (25 July 2023)

With HealthierSG and Singapore's push for preventive health in full swing, attention has also turned towards the accompanying need to manage frailty and optimise the intrinsic capacity of Singapore's ageing population in a systematic manner—efforts critical for healthy ageing.

GERI's Knowledge to Practice Series webinar on the theme of "Frailty Conversations: Intrinsic Capacity Matters" sought to tap into this growing policy and public health momentum in Singapore by assembling related research by GERI for a timely discussion. Topics covered included intrinsic capacity measurement and operationalisation, frailty assessment and community-delivered exercise interventions. A synopsis of each presentation can be found in our Knowledge to Practice Series Webinar Brief: click here [PDF, 175 KB].

Organised by GERI in collaboration with the Ministry of Health (MOH), Chapter of Geriatricians and Society for Geriatric Medicine, the webinar attracted 264 participants across policy divisions, primary, acute and community care, universities and more. Click here [PDF, 430 KB] for the programme and speakers.

In his opening remarks, guest speaker Associate Professor Dan Yock Young, Deputy Director-General of Health at the Health Services Group, MOH, observed that frailty should not be merely viewed as a consequence of ageing, but rather, as a complex interplay between biological, physiological, psychological and social factors.

Given the spike in frailty and its ramifications for vulnerable groups and their caregivers, he said that a multidimensional approach was needed to prevent, detect and manage frailty, and to optimise functional ability among older adults, thereby delaying or preventing functional decline.

Considering the recommendations of the World Health Organisation (WHO)'s Integrated Care of Older Persons (ICOPE) framework [PDF, 621 KB], Associate Professor Dan shared MOH's three focus areas for frailty: raising public awareness on preventive measures, proactive frailty identification in community and primary care, and developing guidelines to harmonise care and integration across the ecosystem. On the latter, he thanked GERI for its contributions in developing the Ministry's National Frailty Strategy and Frailty Implementation Workgroup.

During the Q&A discussion, Dr Rachel Cheong, Joint Faculty, GERI and Consultant, Geriatric Medicine at Khoo Teck Puat Hospital, likened the concepts of frailty and intrinsic capacity to two faces of the same coin, wherein intrinsic capacity represents one's physical and mental reserves whilst frailty represents one's vulnerability of deterioration.

Responding to another participant's question on exercise programmes for frail older adults, Dr Tou Nien Xiang, Research Fellow, GERI, pointed to evidence that resistance, aerobic and balance training exercises were beneficial, but stressed that sustaining such physical activity was just as essential.

The Q&A also highlighted important gaps for future research, such as over the choice of instruments that could be used to pilot measurements of intrinsic capacity in Singapore – of which there is currently no local consensus – and the validated mapping of the severity of frailty across different frailty scales.

In closing, Associate Professor Ding Yew Yoong, Executive Director, GERI, commented on the role played by research in contributing evidence to tackle such national challenges. Beyond the project findings shared at the webinar, he also noted GERI's contributions through its collaborative studies on the Geriatric Services Hub frailty intervention programme and the WHO ICOPE framework.

"How can Singapore be frailty-ready and optimise the intrinsic capacity of our older population? No single actor can move the needle, but whole-of-society and whole-of-system contributions and partnerships are needed," observed Associate Professor Ding.

For more information about the presentations, please email us at enquiry@geri.com.sg.