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The Frailty Trajectory Model (FTM) reframes frailty into three actionable subtypes—remediable, steady-state, and progressive—each linked to expected decline and treatment response. 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However, prevailing definitions and measurements treat frailty as a single, uniform condition, thereby limiting its clinical utility by overlooking important differences in root causes, trajectory, and prognosis [2] . The following cases illustrate how these shortcomings manifest in clinical practice:  \n1. An 85-year-old married man with severe-stage dementia and apathy, occasionally agitated, receives intravesical Bacillus Calmette-Guérin (BCG) for non-muscle-invasive bladder cancer.  \n2. A 78-year-old married man with post-stroke weakness walks independently with a walker but requires assistance with transfers and most basic activities. Although physically limited, he is cognitively intact and enjoys a good quality of life.  \nDespite their distinct medical profiles and future outlooks, these two patients could be assigned identical frailty scores. Moreover, at the individual level, a patient may receive discordant scores depending on the assessment method used—such as the Fried Phenotype, Clinical Frailty Scale, Frailty Index, or Edmonton Frail Scale [3–6]. These inconsistencies undermine efforts to construct a cohesive frailty narrative that informs outcomes and guides care.  \n1 | The Frailty Trajectory Model (FTM)  \nThe FTM is a decision-oriented framework that categorizes frailty into distinct subtypes based on underlying factors,  \nexpected trajectory, and anticipated response to treatment. The model defines three forms of frailty, described as subtypes:  \n1. Remediable frailty: Related to reversible conditions (e.g., hip osteoarthritis or aortic stenosis) that can improve with treatment.  \n2. Steady-state frailty: Related to non-progressive conditions (e.g., post-stroke deficits). Although not reversible, targeted interventions can maintain or improve function.  \n3. Progressive frailty: Associated with conditions causing inevitable decline (e.g., neurodegenerative disease or advanced organ failure) . In early stages, targeted interventions may help, but as frailty progresses, treatment effectiveness declines, vulnerability increases, and a shift toward comfort becomes a priority.  \nDetermining the appropriate subtype should occur during periods of clinical stability to reflect a person's usual health.  \nThe FTM serves as an antidote to the one-size-fits-all approach to frailty management. While traditional frailty care typically aims to slow decline—an appropriate goal for remediable and steady-state frailty—it is less effective in progressive frailty, where deterioration is expected [7]. The FTM addresses this gap by reframing progressive frailty as a distinct life stage calling for honest care planning, avoidance of burdensome treatments, and supportive measures for patients and their care partners.  \n“The FTM serves as an antidote to the one-size-fits-all approach to frailty management.”  \nThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.  \n© 2025 The Author(s). Journal of","cbCaigX6FFzSiJvT","https://ap.wps.com/l/cbCaigX6FFzSiJvT","pdf",274480,"English","# The Frailty Trajectory Model (FTM)\n## Managing Progressive Frailty\n### Frailty Care Requires Accurate Information\n### Words Matter\n### Focus on What's Realistic and Achievable","[{\"question\":\"Why do standard frailty definitions and scores limit clinical utility?\",\"answer\":\"They treat frailty as a single uniform condition, overlooking differences in root causes, trajectory, and prognosis. Different assessment methods can also produce discordant scores for the same patient.\"},{\"question\":\"What are the three frailty subtypes in the Frailty Trajectory Model (FTM)?\",\"answer\":\"The FTM defines remediable frailty, steady-state frailty, and progressive frailty. Each subtype is tied to underlying factors, expected trajectory, and anticipated response to treatment.\"},{\"question\":\"What care principles guide management of progressive frailty?\",\"answer\":\"Nine principles guide care to minimize overmedicalization. Key themes include building accurate narratives, using prognostic language that avoids false hope, and prioritizing comfort when decline is inevitable.\"}]","Redefining Frailty: Planning Care Through the Frailty Trajectory Model | PDF",1790710084,13]