**6. The frail senior in the emergency room**

The frail senior is the one who has his homeostatic reserves to the limit, with a high probability of suffering a deleterious outcome. The detection of this patient is fundamental in the emergency services, since in this scenario it is where there is more risk of entering the cascade of functional decline and dependence. It is interesting how the acute disease acts as a trigger, unmasking the frailty picture. Studies have shown how frail senior people in the emergency room have higher rates of hospitalization, functional deterioration, readmissions, and short-term mortality, when compared with non-frail elderly. For the screening of frail elderly people in the emergency department, the ISAR, TRST, deficit accumulation index (DAI), and comprehensive geriatric assessment are recommended in selected patients defined as high risk. Identifying frail elderly allows designing a special care plan, which has shown a decrease in the number of admissions in residence at 30 days, an increase in patient satisfaction, less functional deterioration, fewer readmissions, and without increasing costs. No impact on mortality or institutionalization has been demonstrated [22].
