Ebony Lewis

Understanding Frailty

Frailty is a term that is often used in clinical or research settings to describe someone who has less ability to recover from disease or illness, someone who has less reserve and is more vulnerable. 

Frailty can occur at any age but it gets more common as we get older. Being frail also makes us more likely to need additional care such as care at home or hospital care. But the good news is that frailty can be modified, it can be stabilised or even reversed.  

Our team has several projects that are investigating frailty, from understanding the best ways to measure and approach frailty in community settings to testing ways that we might be able to reduce it. Our current projects are shown below:  

The INTERgenerAtional Clinical Trial In at risk Older adults and preschool childreN (INTERACTION) (ACTRN12622000368730).  

In the INTERACTION trial led by Associate Professor Ruth Peters, we are collecting data to help us understand whether an intergenerational program (that is bringing older adults and pre-schoolers together to complete purposeful structured activities) helps to reduce frailty in the older adults. We are also measuring what happens to the children as we think it will help them with things like school readiness.  

Associated people: Ruth Peters, Ebony Lewis, Mae Lim, Christine Zammit, Nicole Ee, Gail Kenning.  

Understanding frailty in Indigenous populations  

In this study led by Ebony Lewis, we are mapping the rates of frailty in Indigenous adults, looking at what proportion of people have frailty, what proportion are developing frailty over time and what that means for future engagement and care.  

Project 1 – Views that older First Nations people hold about frailty  

To understand the views that older Aboriginal and Torres Strait Islander people in Sydney hold about frailty and any needs and suggestions around frailty and ageing to support health and wellbeing as people age 

Project 2 – Incidence and prevalence of frailty in First Nations Peoples in New South Wales  

To describe the frailty profile of older Aboriginal and Torres Strait people using data from a population-based cohort in NSW 

Associated people: Ebony Lewis, Dr Kylie Radford, Dr Nicole Mealing, A/Prof Ruth Peters.  

Frailty and high blood pressure 

 In this study led by Associate Professor Ruth Peters, we are looking at whether frailty mediates the impact of blood pressure-lowering medication. This is important since both high blood pressure and frailty become more common as we get older.  

The INTERgenerAtional Clinical Trial In at risk Older adults and preschool childreN (INTERACTION) (A

There is increasing evidence to show that intergenerational interaction is beneficial for older adults and children alike. Higher levels of social engagement in older adults have been associated with better physical and cognitive function and wellbeing. Time spent with older adults has been linked to enhanced social and personal skills in children. However, familial intergenerational interaction is falling despite rising numbers of community-based older adults. In Australia alone approximately 15% of the total population are aged 65 and over, up from 5% in the 1920s and estimated to increase to 22% (8.8 million) in the next 30-40 years. Employment and economic factors drive greater geographical mobility of working age adults, resulting in increased separation from older family members with 40% of Australians aged 75-84 and 51% of those 85 and over living alone. Recent television series in Australia and the United Kingdom, have raised awareness and enthusiasm for intergenerational activities as an opportunity that could be realised within communities. However, while intergenerational programs are gaining in popularity globally, evidence for best practice in this area remains scarce. 

In the INTERACTION trial led by Associate Professor Ruth Peters, we are collecting data to help us understand whether an intergenerational program (that is bringing older adults and pre-schoolers together to complete purposeful structured activities) helps to reduce frailty in the older adults. We are also measuring what happens to the children as we think it will help them with things like school readiness.  

Our INTERACTION trial builds on our previous pilot work in the Intergenerational Integration Initiative (3i) project. In our previous work we answered three questions: We systematically reviewed the scientific evidence for community-based intergenerational programs and found that this was lacking. We asked the public and local community members what they thought about intergenerational programs and found that people are supportive and perceive such programs to be helpful. Finally, we ran a successful small pilot program in a Sydney community to test whether such programs were feasible. Our published work on the 3i project can be found here https://pubmed.ncbi.nlm.nih.gov/33567363/, and here https://www.mdpi.com/2076-0760/10/10/374  

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