Frailty is a common but often under-recognised clinical syndrome that has significant implications for health outcomes in older adults. In this episode, we explore how frailty develops, who is most at risk, and why early identification matters. We discuss practical approaches to assessment in primary care, the consequences of frailty, and evidence-based strategies to help patients maintain function, independence, and quality of life with specific discussions around Te Ao Māori perspective.

Practical clinical pearls:

• Watch for the frailty pattern: unintentional weight loss, reduced activity, fatigue, slowed gait, and falls.
• Use the corridor as part of the consult: gait speed, chair rise, grip strength, and how they move tell you a lot.
• Ask family/whānau for collateral history, because gradual decline is often noticed there first.
• Think multifactorially: frailty is linked to sarcopenia, multimorbidity, polypharmacy, social isolation, nutrition, and environmental barriers.
• Prioritize resistance training and adequate protein intake; those are among the most effective preventive strategies.
• Review medications carefully, especially sedatives, anticholinergics, and overly tight diabetes or blood pressure treatment.
• Use frailty to change decision-making: shift from disease-only management to goals-of-care and whole-person planning.
• Keep care strengths-based and culturally grounded, especially for Māori patients: focus on what matters, what supports them, and what gives them mana.
• Don’t wait until someone is clearly frail; midlife is the right time to start prevention.
• Frailty is not just a label — it’s a signal to act.

Resources:

1. Health Quality & Safety Commission New Zealand. Frailty | Te Wairuhi: Frailty care guides 2023 [Internet]. Wellington: Health Quality & Safety Commission New Zealand; 2023 [cited 2026 Jun 17]. Available from: Frailty | Te Wairuhi: Frailty care guides 2023
2. Healthify. Clinical Frailty Scale [Internet]. Auckland: Healthify He Puna Waiora; [cited 2026 Jun 17]. Available from: Clinical Frailty Scale
3. Gee S, Bullmore I, Cheung G, et al. It's about who they are and what they can do: Māori perspectives on frailty in later life. N Z Med J. 2021;134(1535):17-24. Available from: ResearchGate article

Biography:

Dr Helen Kenealy is a dual-trained General Physician and Geriatrician with extensive experience in the care of older adults. She is currently Chief Clinical and Risk Officer at Metlifecare, where she oversees clinical quality, governance, risk management, health and safety, and digital health innovation across retirement living and aged care services.

Helen is passionate about delivering high-quality care for older adults and supporting people to maintain independence, function, and quality of life as they age. She brings extensive expertise in frailty, healthy ageing, comprehensive geriatric assessment, and the healthcare systems that support older New Zealanders.

Listen here:

https://podcasts.apple.com/nz/podcast/frailty-w-dr-helen-kenealy/id1845748299?i=1000783687000

https://open.spotify.com/episode/5jbMGUOgMGMDTzBONMuOsS?si=6ef1d31419394317

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