Scored four of five on the Fried phenotype, a composite widower in NU584's Unit 2 write-up receives a looser A1c goal, one fewer drug and a strength program. Searches like "nu 584 unit 2 assignment example", "nu584 unit 2 sample" and "nu584 unit 2 example" land here.
Four of Five Fried Criteria After His Wife Died: A Frailty Assessment Write-Up That Changes an 82-Year-Old's Diabetes Plan
[Student Name]
Purdue University Global
NU584: AGNP II - Primary Care of the Frail Elderly
Unit 2 Frailty Assessment Write-Up
[Instructor Name]
[Date]
The patient is a composite; measurements and doses are bracketed.
Measurement
Each criterion follows the published method of the frailty phenotype (Fried et al., 2001).
1. Weight loss. Method: clinic records. Cutoff: more than 4.5 kg or 5 percent unintentionally in the prior year. Result: [5.4] kg over [ten] months, since his wife's death. Positive.
2. Exhaustion. Method: two CES-D items, how often in the past week "everything I did was an effort" and "I could not get going." Cutoff: either occurring three or more days a week. Result: one or two days a week. Negative.
3. Weakness. Method: hand dynamometer, dominant hand, best of three. Cutoff for a man with his BMI of [23]: [30] kg or less. Result: [22] kg. Positive.
4. Slowness. Method: time to walk 15 feet at usual pace. Cutoff for a man of his height, over 173 cm: 6 seconds or more. Result: [8.1] seconds. Positive.
5. Low activity. Method: a short leisure-time activity questionnaire, converted to kilocalories a week. Cutoff for men: under 383 kcal. Result: [210] kcal; his son says the armchair is where he passes his days. Positive.
Four of five criteria are positive, which places him as frail rather than prefrail, and the one negative, exhaustion, is the criterion he could least easily describe.
Interpretation
Frail, by the phenotype. The phenotype measures the state; it does not say why. His frailty followed his wife's death, and three explanations for the weight loss each need a different remedy.
Depression. His GDS-15 score is [7], suggesting depression. Grief can become depression, and depression suppresses appetite and activity.
Poor dentition. His dentures became loose after he lost weight, and he now avoids meat and raw fruit, which reduces protein and calories and feeds the weight loss.
Illness. No new symptoms suggest cancer or another illness, but his weight loss meets the threshold for evaluation, and basic labs are due.
Function has slipped too. Two instrumental activities of daily living, managing money and shopping, are now handled by his son. His wife used to cook, and he now eats simple meals or skips them.
Why Measure Rather Than Judge
A clinician who knew Mr. [O.] could have judged him frail at a glance. The measured phenotype was used instead for three reasons. First, it gives numbers that can be repeated in three months, so improvement or decline is visible rather than impressionistic. Second, it separated the criterion he did not meet, exhaustion, from the four he did, which matters: a man who does not feel exhausted but is weak, slow and inactive may respond well to exercise, since his limit is strength and habit rather than fatigue. Third, measuring grip and gait in the room made the findings concrete for him. He watched the dynamometer read 22 and said he used to carry two crates of apples at a time. That comparison did more to motivate him than any explanation of frailty would have.
What Had Already Happened With His Glucose
The plan's change to his diabetes regimen was not only precautionary. On review of his meter, two readings in the past month were below 70 mg/dL, both in the late morning on days he had skipped breakfast. He had not noticed any symptoms, which is itself a warning, since older adults on sulfonylureas may not feel the usual shakiness and sweating before a low. His son had found him confused one morning and assumed it was grief. That morning may well have been hypoglycemia. The regimen that suited a man who ate three meals a day with his wife no longer suited a man who eats one.
Plan: Old Targets Beside New
Diabetes, before: A1C target below [7.0] percent; [metformin] 1,000 mg twice daily and [glimepiride] [4] mg daily. Diabetes, after: A1C target below [8.0] percent; continue [metformin] at a dose adjusted to kidney function; withdraw [glimepiride], tapering to stop over [two] weeks with glucose checks.
The ADA Standards of Care separate older adults into healthy, complex or intermediate, and very complex or poor health, with less stringent glycemic goals as health becomes more complex (American Diabetes Association Professional Practice Committee, 2025). His frailty, his dependence in two IADLs and his depression place him in the complex or intermediate group, for which an A1C below 8.0 percent is appropriate. The sulfonylurea goes because hypoglycemia in a frail man living alone, eating irregularly, risks a fall that no one sees. His recent A1C of [6.6] percent shows his current regimen is tighter than he needs and more dangerous than it is worth.
Frailty interventions, following the ICFSR guidelines (Dent et al., 2019):
1. Progressive resistance exercise, through physical therapy twice a week for [twelve] weeks, then a home program.
2. Protein and calorie support: a dietitian referral; protein at each meal; oral nutritional supplements while weight is regained; denture reline by his dentist.
3. Medication review: all medicines checked for effects on appetite, balance and cognition.
4. Depression: a discussion of grief and depression, referral to a bereavement group, and an offer of treatment, with [mirtazapine] considered, since it can improve appetite and sleep, weighed against its fall risk.
5. Labs: complete blood count, metabolic panel, TSH, and age-appropriate cancer screening review.
Reassessment
Frailty criteria, weight, grip and gait speed repeated in [three] months. Glucose log review in [two] weeks after the glimepiride taper. If he regains weight and strength, the phenotype may move him back to prefrail, which is a realistic goal. Frailty is not a one-way path; resistance training and nutrition can improve grip, gait and weight in frail older adults, and the ICFSR guidelines recommend both as first-line interventions for exactly this reason (Dent et al., 2019).
What He Chose
He agreed to physical therapy and the dentist, and asked to wait on an antidepressant until he had tried the bereavement group, which his daughter-in-law had found through their church. He agreed to stop the glimepiride once he understood that it could make him confused on mornings he skipped breakfast. His goal, in his words, was "to walk the rows again," the orchard he still visits with his son. That goal is written at the top of the plan, and each intervention is chosen because it serves it, from the leg strength he will need on uneven ground to the steady glucose that keeps him safe while he walks alone.
References
American Diabetes Association Professional Practice Committee. (2025). Standards of care in diabetes 2025. Diabetes Care, 48(Suppl. 1), S1-S352. https://diabetesjournals.org/care
Dent, E., Morley, J. E., Cruz-Jentoft, A. J., Woodhouse, L., Rodríguez-Mañas, L., Fried, L. P., Woo, J., Aprahamian, I., Sanford, A., Lundy, J., Landi, F., Beilby, J., Martin, F. C., Bauer, J. M., Ferrucci, L., Merchant, R. A., Dong, B., Arai, H., Hoogendijk, E. O., ... Vellas, B. (2019). Physical frailty: ICFSR international clinical practice guidelines for identification and management. Journal of Nutrition, Health and Aging, 23(9), 771-787. https://doi.org/10.1007/s12603-019-1273-z
Fried, L. P., Tangen, C. M., Walston, J., Newman, A. B., Hirsch, C., Gottdiener, J., Seeman, T., Tracy, R., Kop, W. J., Burke, G., & McBurnie, M. A. (2001). Frailty in older adults: Evidence for a phenotype. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56(3), M146-M156. https://doi.org/10.1093/gerona/56.3.M146
How this NU584 Unit 2 example is structured
Measurement comes first and stays separate from judgment, so each criterion can be checked against the published method (Fried and colleagues, 2001). The interpretation section explains the score and then asks why he became frail, since weight loss after bereavement could reflect depression, poor dentition or illness, and each has a different remedy. The plan is the longest section. It uses the ADA Standards of Care categories for older adults to move his glycemic goal, reasoning that frailty and IADL dependence place him in the complex or intermediate group, and it removes the sulfonylurea because hypoglycemia in a frail man living alone risks a fall no one sees. The frailty-specific interventions follow the ICFSR guidelines (Dent and colleagues, 2019): progressive resistance exercise through physical therapy, protein and calorie support given the weight loss, and a medication review. A reassessment date closes the plan.
Get an NU584 Unit 2 example written to your instructions
Send the composite patient from your Unit 2 prompt and say which frailty instrument your section names, if any, with the rubric. We score that patient criterion by criterion, then rewrite the targets and regimen around the result with every drug bracketed. It returns within 24-48h, and the first request is free. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
NU584 Unit 2 questions, answered
What if the case does not give grip strength or activity data?
Say so, and score only what the case supports. A phenotype with two criteria unmeasured cannot confirm frailty, but it can support prefrailty and justify completing the assessment. Some sections accept the Clinical Frailty Scale instead when data are thin, since it relies on clinical description. Naming the gap is safer than inventing a value.
Which glucose target fits a frail older adult?
Most papers cite the older adult section of the ADA Standards of Care, which relaxes the A1c goal as health status becomes more complex and, for the most complex patients, advises against relying on A1c and toward preventing hypoglycemia. State which category the patient fits and why. That reasoning appears in the sample with the numbers bracketed.
Does a frailty score change prognosis in the paper?
It often should. Frailty predicts falls, hospitalization and mortality, and a paper can say so with a source without giving a precise life expectancy. That context supports decisions about screening, treatment intensity and goals of care in later units. Keep the language measured: frailty raises risk, and some of it can improve with exercise and nutrition.