Frailty and Elderly Care Research

The award winning Frailty and Elderly Care research group, part of the Academic Unit for Ageing and Stroke Research, addresses the needs of an ageing population. This population has life-long accumulated exposures which contribute to chronic disease and give rise to associated physical and mental health co-morbidities. In response to the health service challenges posed by multi-morbidity in the elderly, our research encompasses:

  • The nature of frailty in the elderly and its impact on service use.
  • Mental health morbidity (delirium, dementia, depression) in physical healthcare settings.
  • Evaluation of services for older people, for example community hospitals, day hospitals and intermediate care.

We are a national and international leading centre for frailty research. The development of the Electronic Frailty Index (eFI) led by Andy Clegg, allowing for the first time identification of people with frailty through routine data, has been transformational. Use of the eFI is now in the new General Medical Services contract, a contractual requirement for practices to screen for frailty, allowing them to identify and consider offering treatment options to their frail elderly patients. The eFI, winner of the RCP Excellence in Patient Care Awards 2017, also featured in the 2016 NICE Multimorbidity Guideline, is being used by numerous research teams to identify people with frailty in order to develop tailored services, technology and interventions. 


Our recent projects include

(MOCHAA study to understand and optimise community hospital care in the NHS

(PROSPER) Personalised Care Planning for Older People with Frailty

(CARE 75+) The Community Ageing Research Study

(HERO) Home-based Extended Rehabilitation for Older people

Optimising blood pressure management for older people with frailty

(OPTIMISE) Developing a novel system of care targeting risk factors for five manifestations of frailty to maintain the independence of older people in hospital and post-discharge

Community based complex interventions to sustain independence in older people, stratified by frailty: a systematic review and network meta-analysis.

HOMEHEALTH – Enabling health and maintaining independence for older people at home


Who we are

Unit Lead

Professor Anne Forster - Professor of Stroke Rehabilitation and Head of Unit; NIHR Senior Investigator


Senior Academics

Professor Andrew Clegg - Professor of Geriatric Medicine

Dr Elizabeth Teale - Clinical Senior Lecturer in Geriatric Medicine


Emeritus Professor

Professor John Young - Professor of Elderly Care Medicine



Anne Heaven

Dr Jane Smith

Dr Rebecca Hawkins

Dr Alan Wright

Dr Nicola Kime

Caroline Brundle

Nicola Harrison



Matthew Prescott

Dr Sarah Hallas

Ismail Patel

Ruth Illingworth

Gillian Thornton



Dr Faye Wray



Dr Rebecca Hawkins

Dr Lesley Brown           

Dr Sarah Hallas

Ikhlaq Jacob

Farhat Mahmood



Wendy Andrusjak

Gillian Thornton


NIHR Academic Clinical Lecturer 

Dr Oliver Todd


Funding sources

National Institute for Health Research

Dunhill Medical Trust 


Key publications

Hale M, Shah S, Clegg A. Frailty, inequality and resilience. Clinical Medicine 2019;19(3):219-223. doi: 10.7861/clinmedicine.19-3-219.

Todd OM, Wilkinson C, Hale M, Wong NL, Hall M, Sheppard JP, McManus RJ, Rockwood K, Young J, Gale CP, Clegg A.  Is the association between blood pressure and mortality in older adults different with frailty? A systematic review and meta-analysis. Age Ageing 2019. afz072,

Brown L, Young J, Teale E, Santorelli G, Clegg A. A Cross-Sectional Study of the Impact of Pain in Older People with Frailty: Findings from the Community Ageing Research 75+ (CARE75+) Study. Advances in Geriatric Medicine and Research 2019;1:e190002.

Heaven A, Brown L, Young J, Teale E, Hawkins R, Spilsbury K, Mountain G, Young T, Goodwin V, Hanratty B, Chew-Graham C, Brundle C, Mahmood F, Jacob I, Daffu-O’Reilly A, Clegg A. Community ageing research 75+ study (CARE75+): an experimental ageing and frailty research cohort. BMJ Open 2019;9(3):e026744. doi: 10.1136/bmjopen-2018-026744

Crocker T, Brown L, Clegg A, Farley K, Franklin M, Simpkins S. Young J. Quality of life is substantially worse for community-dwelling older people living with frailty: systematic review and meta-analysis. Quality of Life Research 2019;1-16

Wilkinson C, Todd O, Clegg A, Gale CP, Hall M. Management of atrial fibrillation for older people with frailty: a systematic review and meta-analysis. Age Ageing 2019;48(2)196–203. doi: 10.1093/ageing/afy180

Brundle C, Heaven A, Brown L, Teale E, Young J, West R, Clegg A.Convergent validity of the electronic frailty index. Age and Ageing 2018.

Godfrey M, Young J, Shannon R, Skingley A, Woolley R, Arrojo F, Brooker D, Manley K, Surr CA. The Person, Interactions and Environment Programme to improve care of people with dementia in hospital: a multisite study. Health Services and Delivery Research 2018;6(23).

Clegg A, Hassan-Smith Z. 2018. Frailty and the endocrine system. The Lancet Diabetes and Endocrinology;6(9), pp. 743-752

Teale EA, Munyombwe T, Siddiqi N, Schuurmans M, Young J. A prospective observational study to investigate utility of the Delirium Observational Screening Scale (DOSS) to detect delirium in care home residents. Age Ageing 2018;47(1):56-61