Background
In 2010, the European Working Group on Sarcopenia in Older People
(EWGSOP) published a sarcopenia definition that aimed to foster advances in
identifying and caring for people with sarcopenia. In early 2018, the
Working Group met again (EWGSOP2) to update the original definition in order
to reflect scientific and clinical evidence that has built over the last
decade. This paper presents our updated findings.
Objectives
To increase consistency of research design, clinical diagnoses, and
ultimately, care for people with sarcopenia.
Recommendations
Sarcopenia is a muscle disease (muscle failure) rooted in adverse
muscle changes that accrue across a lifetime; sarcopenia is common among
adults of older age but can also occur earlier in life. In this updated
consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength
as a key characteristic of sarcopenia, uses detection of low muscle quantity
and quality to confirm the sarcopenia diagnosis, and identifies poor
physical performance as indicative of severe sarcopenia; (2) updates the
clinical algorithm that can be used for sarcopenia case-finding, diagnosis
and confirmation, and severity determination, and (3) provides clear cut-off
points for measurements of variables that identify and characterize
sarcopenia.
Conclusions
EWGSOP2’s updated recommendations aim to increase awareness
of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls
for healthcare professionals who treat patients at risk for sarcopenia to
take actions that will promote early detection and treatment. We also
encourage more research in the field of sarcopenia in order to prevent or
delay adverse health outcomes that incur a heavy burden for patients and
healthcare systems.
AimThis paper discusses the critical determinants of pressure ulcer development and proposes a new pressure ulcer conceptual framework.BackgroundRecent work to develop and validate a new evidence-based pressure ulcer risk assessment framework was undertaken. This formed part of a Pressure UlceR Programme Of reSEarch (RP-PG-0407-10056), funded by the National Institute for Health Research. The foundation for the risk assessment component incorporated a systematic review and a consensus study that highlighted the need to propose a new conceptual framework.DesignDiscussion Paper.Data SourcesThe new conceptual framework links evidence from biomechanical, physiological and epidemiological evidence, through use of data from a systematic review (search conducted March 2010), a consensus study (conducted December 2010–2011) and an international expert group meeting (conducted December 2011).Implications for NursingA new pressure ulcer conceptual framework incorporating key physiological and biomechanical components and their impact on internal strains, stresses and damage thresholds is proposed. Direct and key indirect causal factors suggested in a theoretical causal pathway are mapped to the physiological and biomechanical components of the framework. The new proposed conceptual framework provides the basis for understanding the critical determinants of pressure ulcer development and has the potential to influence risk assessment guidance and practice. It could also be used to underpin future research to explore the role of individual risk factors conceptually and operationally.ConclusionBy integrating existing knowledge from epidemiological, physiological and biomechanical evidence, a theoretical causal pathway and new conceptual framework are proposed with potential implications for practice and research.
This study showed that the TFI is a valid instrument to predict disability, many indicators of health care utilization, and quality of life of older people, 1 and 2 years later.
The model should be able to serve as a basis for further scientific research on frailty. The model also provides a framework for the development of a measurement instrument which can be used for the identification of frail elderly persons.
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