Frailty, Acute Brain Dysfunction, and Posthospitalization Disability Outcomes in Critically Ill Older Adults

Author(s): By Corrielle Caldwell, MD, Joe Verghese, MBBS, MS, Michelle N. Gong, MD, MS,, Mimi Kim, ScD, and Aluko A. Hope, MD, MSCE

Contact Hours 1.00

CERP A 1.00

Expires Jul 01, 2026

Topics: Delirium, Neurology

Population: Adult

Member: Free
NonMember: $10.00

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Activity Summary

Required reading for all learners: Implicit Bias impacts patient outcomes

In this study, we enrolled 302 adults who were admitted to the ICU and assessed for pre-hospital frailty using the Clinical Frailty Scale (CFS), a judgment-based frailty assessment tool in which the patient is scored from 1-9: 1-3 is considered fit; 4 is considered vulnerable or very mildly frail; ≥ 5 is considered mild to severely frail; 9 is terminally ill. We assessed level of consciousness and delirium daily using the Richmond Agitation and Sedation Scale (RASS) and the Confusion Assessment Method-ICU (CAM-ICU) and defined acute brain dysfunction as the presence of delirium or persistent coma (RASS -4 or -5) over the first 14 days in ICU. Both frailty and acute brain dysfunction were associated with increased risk of severe physical disability or death at 6 months after hospital discharge and acute brain dysfunction was an important mediator of the effect of frailty on severe disability outcomes.


  • Describe how to use the Clinical Frailty Scale to identify acutely ill adults living with frailty.
  • Identify the 4 features of delirium assessed by the Confusion Assessment Method for the Intensive Care Unit.
  • List 3 possible nursing interventions to use with hospitalized adults living with frailty to prevent functional decline after discharge.

Continuing Education Disclosure Statement

Successful Completion

Learners must attend/view/read the entire activity, read Implicit Bias impacts patient outcomes, and complete the associated evaluation to be awarded the contact hours or CERP. No partial credit will be awarded.


The American Association of Critical-Care Nurses is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Provider approved by the California Board of Registered Nursing, Provider number CEP 1036, for 1.00 contact hours.

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