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

Autor: Miriam Marie Rosé Vollenbroek-Hutten, Duygu Sezgin, Aaron Liew, Deirdre Lang, John Cooke, Mark O'Donovan, Andrew Clegg, Francisco Orfila Pernas, Cafer Balci, Maria Therese Cooney, Kenneth Rockwood, William Molloy, Leocadio Rodríguez Mañas, Rónán O'Caoimh, Regina Roller-Wirnsberger, Roman Romero-Ortuno, Roger Clarnette, Jean Woo, Constança Paúl, Anne Hendry, Carol Holland, Siobhan Kennelly, Ángel Rodríguez-Laso, Nicola Fairhall, João Apóstolo, Emer Ahern, Karen Bandeen-Roche, Giuseppe Liotta, Diarmuid O'Shea, Maddalena Illario, Burcu Balam Yavuz
Přispěvatelé: Biomedical Signals and Systems, TechMed Centre
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Archives of Gerontology and Geriatrics, 99:104586. Elsevier
ISSN: 0167-4943
Popis: 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.
Databáze: OpenAIRE
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