Abstract

Stroke care is continually improving. Improvements in primary prevention, rapid diagnosis and treatment have been associated with national reductions in stroke mortality. Increasing availability of intravenous thrombolysis and mechanical thrombectomy has brought the discussion back to one of the most fundamental management questions in Geriatrics: “Is this the right decision for this particular patient?” The understanding of frailty as a syndrome of reduced physiological reserve has been widely adopted. Research across many specialities has identified frailty as an influencing factor in mortality and functional recovery, notably with: emergency surgery, intensive care admission and mechanical thrombectomy in acute stroke. The exact mechanisms through which frailty influences these outcomes is under investigation, though it has been suggested that it may be the result of cumulative deficits over time prior to the event rather than the response to the event itself.

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