Frailty associated functional changes in the elderly lead to different problems treating geriatric patients in an intensive care unit. Patients suffering from frailty have less physiological reserves in acute illness, complications are more frequent and recovery is clearly delayed. Frailty is also an established and independent predictor for mortality. Therefore understanding of physiological ageing and knowledge of geriatric syndromes must be part of modern intensive care medicine. The importance of Frailty for intensive care is shown by means of selected clinical pattern.