Early identification of frailty: Developing an international delphi consensus on pre-frailty.

Autor: Sezgin D; Clinical Sciences Institute, School of Medicine, National University of Ireland, Galway, Galway City, Ireland; School of Nursing and Midwifery, National University of Ireland, Galway, Galway City, Ireland., O'Donovan M; Clinical Sciences Institute, School of Medicine, National University of Ireland, Galway, Galway City, Ireland; HRB Clinical Research Facility, Mercy University Hospital, Cork City, Ireland., Woo J; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong., Bandeen-Roche K; Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America., Liotta G; Department of Biomedicine and Prevention, University of Rome 'Tor Vergata', Rome, Italy., Fairhall N; Faculty of Medicine and Health, Sydney School of Public Health, Institute for Musculoskeletal Health, University of Sydney, Sydney, Australia., Rodríguez-Laso A; CIBERFES: CIBER (Centers of the Network of Biomedical Research) thematic area for Frailty and Healthy Ageing. Instituto de Salud Carlos III, Madrid, Spain., Apóstolo J; Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Portugal., Clarnette R; Department of Internal Medical School, University of Western Australia, Crawley, Western Australia., Holland C; Centre for Ageing Research, Division of Health Research, Lancaster University, Lancaster, England, United Kingdom., Roller-Wirnsberger R; Department of Internal Medicine, Medical University of Graz, Graz, Austria., Illario M; Department of Public Health, University of Naples Federico II, and Health innovation Unit, Campania Health Directorate, Naples, Italy., Mañas LR; Hospital Universitario de Getafe, Madrid, Spain., Vollenbroek-Hutten M; University of Twente, Enschede, The Netherlands., Doğu BB; Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey., Balci C; Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey., Pernas FO; Institut Universitari d'Investigació en Atenció Primaria Jordi Gol, Barcelona, Spain., Paul C; ICBAS, CINTESIS, University of Porto, Porto, Portugal., Ahern E; St Lukes General Hospital, Kilkenny, Ireland., Romero-Ortuno R; School of Medicine, Trinity College Dublin, Dublin City, Ireland., Molloy W; Centre for Gerontology and Rehabilitation, University College Cork, Cork City, Ireland., Cooney MT; St Vincent's University Hospital, Dublin City, Ireland., O'Shea D; St Vincent's University Hospital, Dublin City, Ireland., Cooke J; University Hospital Waterford, Waterford City, Ireland., Lang D; Office of the Nursing and Midwifery Services, Health Service Executive of Ireland, Dublin, Ireland., Hendry A; University of the West of Scotland, Scotland, United Kingdom., Kennelly S; Connolly Hospital, Blanchardstown, Dublin City, Ireland., Rockwood K; Division of Geriatric Medicine, Dalhousie University Faculty of Medicine, Halifax, Canada., Clegg A; School of Medicine, University of Leeds, England, United Kingdom., Liew A; Clinical Sciences Institute, School of Medicine, National University of Ireland, Galway, Galway City, Ireland; Portiuncula University Hospital, Galway, Ireland., O'Caoimh R; Clinical Sciences Institute, School of Medicine, National University of Ireland, Galway, Galway City, Ireland; Centre for Gerontology and Rehabilitation, University College Cork, Cork City, Ireland; Mercy University Hospital, Grenville Place, Cork City, Ireland. Electronic address: rocaoimh@muh.ie.
Jazyk: angličtina
Zdroj: Archives of gerontology and geriatrics [Arch Gerontol Geriatr] 2022 Mar-Apr; Vol. 99, pp. 104586. Date of Electronic Publication: 2021 Nov 20.
DOI: 10.1016/j.archger.2021.104586
Abstrakt: Background: Frailty is associated with a prodromal stage called pre-frailty, a potentially reversible and highly prevalent intermediate state before frailty becomes established. Despite being widely-used in the literature and increasingly in clinical practice, it is poorly understood.
Objective: To establish consensus on the construct and approaches to diagnose and manage pre-frailty.
Methods: We conducted a modified (electronic, two-round) Delphi consensus study. The questionnaire included statements concerning the concept, aspects and causes, types, mechanism, assessment, consequences, prevention and management of pre-frailty. Qualitative and quantitative analysis methods were employed. An agreement level of 70% was applied.
Results: Twenty-three experts with different backgrounds from 12 countries participated. In total, 70 statements were circulated in Round 1. Of these, 52.8% were accepted. Following comments, 51 statements were re-circulated in Round 2 and 92.1% were accepted. It was agreed that physical and non-physical factors including psychological and social capacity are involved in the development of pre-frailty, potentially adversely affecting health and health-related quality of life. Experts considered pre-frailty to be an age-associated multi-factorial, multi-dimensional, and non-linear process that does not inevitably lead to frailty. It can be reversed or attenuated by targeted interventions. Brief, feasible, and validated tools and multidimensional assessment are recommended to identify pre-frailty.
Conclusions: Consensus suggests that pre-frailty lies along the frailty continuum. It is a multidimensional risk-state associated with one or more of physical impairment, cognitive decline, nutritional deficiencies and socioeconomic disadvantages, predisposing to the development of frailty. More research is needed to agree an operational definition and optimal management strategies.
(Copyright © 2021. Published by Elsevier B.V.)
Databáze: MEDLINE
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