Abstract
Frailty is highly prevalent with increasing age and contributes to adverse health outcomes. Prior to medical and surgical intervention for the treatment of pelvic floor disorders (PFD), a comprehensive evaluation is necessary to evaluate frailty. Beyond a standard assessment, the care of frail patients requires consideration of additional factors including functional ability, cognitive impairment, and the role of caregivers. In this article, we review the current literature on PFD, specifically urinary and fecal incontinence and pelvic organ prolapse, in frail individuals and highlight the risks and benefits of various treatment options. Multiple tools are available to screen and assess for frailty in the general population. Growing evidence demonstrates that the development of functional limitations is the initial manifestation of frailty and may further translate to an increased risk of surgical complications. No standardized method for screening and measurement of frailty currently exists. Independent of the individual assessment metric to measure frailty, there is an associated increased risk of adverse events related to treatments. Management of PFD in the frail population requires a tailored approach and necessitates consideration beyond objective data to the subjective, cognitive, and quality of life implications of treatment.
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