Counteracting inflammation and insulin resistance with diet and exercise: A strategy for frailty prevention?

Zuliani, Giovanni; Soavi, Cecilia; Maggio, Marcello; Vita, F. De; Cherubini, Antonio; Volpato, Stefano

doi:10.1016/j.eurger.2014.11.010

Cited by 11 publications

(5 citation statements)

References 170 publications

(177 reference statements)

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“…There is a belief that frailty could be reversed if there was a process for early screening followed by appropriate interventions (Cesari et al, ). Interventions require to be multi‐factorial and include physical exercise, adequate intake of calories, protein, vitamin D supplementation and increased social support to be most effective (Luger et al, ; Zuliani et al, ). A recent systematic review showed that a combination of muscle strength training and protein supplementation was the most effective intervention to delay or reverse frailty in older people and additionally the easiest to implement in primary care (Travers, Romero‐Ortuno, Bailey, & Cooney, ).…”

Section: Introductionmentioning

confidence: 99%

Preventing frailty in older people: An exploration of primary care professionals' experiences

Obbia

Graham

Duffy

et al. 2019

Int J Older People Nursing

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Background: An increasing number of the ageing population worldwide is at risk of becoming frail and incapacitated. This has the potential to impact not only on the well-being of individuals but also on the sustainability of healthcare systems.Objective: The aim of this study was to explore the views and experiences of frailty from the perspective of primary care professionals, including nurses, who work directly with older people within the community. Methods:A qualitative approach with a descriptive phenomenological methodology was used, which focused on exploration of primary care professionals' current experiences of early detection and prevention of the onset of frailty. Four multiprofessional focus groups were held with a total of thirty-three primary care professionals who worked with older people as part of their daily role. Participants included district nurses, general practitioners, home care workers, physiotherapists and social workers. Results: Professional views encompassed typical patterns of ageing, loneliness, presence of comorbidity, disability and end of life, with social conditions prevalent in most frailty they encountered. Three main themes emerged: the psychosocial nature of frailty, late detection of frailty and barriers to the feasibility of prevention. Physical frailty was considered a constituent part of ageing, which recognised the presence of a skills gap related to the detection of the early signs of frailty. Present health and social care systems are not designed to prevent frailty, and the competencies required by health and social care professionals are not usually included as part of their training curricula. This may hinder opportunities to intervene to prevent associated decline in ability of older adults. Conclusions: To enhance the early assessment of frailty and the planning of preventive multi-factorial interventions in primary care and community settings, training and effective detection strategies should be incorporated into the role and daily care activities of primary care professionals.

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Section: Introductionmentioning

confidence: 99%

Preventing frailty in older people: An exploration of primary care professionals' experiences

Obbia

Graham

Duffy

et al. 2019

Int J Older People Nursing

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“…Given that frailty is dynamic, research suggests it can be considered a malleable and manageable condition and, therefore, there may be opportunities along its pathway to halt, reverse, manage and/or prevent its adverse consequences and worsening (Andreasen et al 2015; Cameron et al 2013; Cesari et al 2016; Gill et al 2002; Kapan et al 2016; Ng et al 2015; Theou et al 2011). Positive prevention strategies include being pro-active about one's own life and engaging in healthy lifestyle choices, particularly in terms of maintaining a healthy weight, adequate nutrition, exercise and not smoking (Zuliani et al 2015). Physical exercise, particularly resistance exercise, has been well studied and has been found to be beneficial in terms of preventing and treating frailty and improving functional performance (Alexander et al 2001; De Vreede et al 2005; Manini et al 2007).…”

Section: Introductionmentioning

confidence: 99%

“…Physical exercise, particularly resistance exercise, has been well studied and has been found to be beneficial in terms of preventing and treating frailty and improving functional performance (Alexander et al 2001; De Vreede et al 2005; Manini et al 2007). Changes to diet alone are less successful in preventing or reversing frailty without an associated exercise component (Zuliani et al 2015), although an adequate intake of protein, calories and vitamin D are critical (Zuliani et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Understanding frailty: meanings and beliefs about screening and prevention across key stakeholder groups in Europe

et al. 2017

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Innovative methods to manage frailty are critical to managing the needs of an ageing population. Evidence suggests there are opportunities to reverse or prevent frailty through early intervention. However, little is known about older adults', families' and practitioners' beliefs about the malleability of frailty. This study examined European stakeholders' accounts of the acceptability and feasibility of frailty screening and prevention to inform future intervention development. Semi-structured focus groups and individual interviews were conducted in three European Union countries (Italy, Poland and the United Kingdom) with key stakeholders -frail and non-frail older adults, family care-givers, and health and social care professionals. Thematic analysis identified four themes: synchronicity between the physical and the psychological in frailty, living with frailty in the social world, the need for a new kind of care, and screening for and preventing frailty. Findings emphasised the need for a holistic approach to frailty care and early intervention. Integrated care services and advocacy were important in the organisation of care. Central to all stakeholders was the significance of the psychological and social alongside the physical elements of frailty and frailty prevention. Support and care for older adults and their

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“…Management of frailty includes the coupling of effective prevention with directed therapeutic approaches [72]. In one study, 188 frail people living at home were randomized to undergo either physical therapy-based intervention or an educational program (control group) [73].…”

Section: Frailty: Multidisciplinary and Interdisciplinary Approachesmentioning

confidence: 99%

Patient Frailty: Key Considerations, Definitions and Practical Implications

Cohen¹,

Paul²,

Nuschke³

et al. 2016

Challenges in Elder Care

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By 2020, the elderly (≥65-year-old) world population is projected to exceed one billion individuals. This demographic megatrend has brought topics such as physiological age and frailty to the forefront of medical research efforts around the globe. The concept of frailty has evolved significantly since the mid-twentieth century. The outdated stereotype of a "thin, stooped, slow octogenarian" has transitioned to a more scientific and objective understanding of the problem. Still, a comprehensive and concise definition of "frailty" remains elusive. Until such a definition is firmly established and universally agreed upon, clinicians continue to rely on the somewhat subjective conceptual framework of today. In this chapter, the authors review key issues pertaining to clinical management of frail patients, including diagnosis/identification, preventive strategies, therapeutic approaches, and common pitfalls. The relationship between frailty, various domains of life, and functional status is also discussed. Finally, we will touch upon the concepts of end-of-life and goals of care, focusing on their relationship to frailty.

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Counteracting inflammation and insulin resistance with diet and exercise: A strategy for frailty prevention?

Cited by 11 publications

References 170 publications

Preventing frailty in older people: An exploration of primary care professionals' experiences

Preventing frailty in older people: An exploration of primary care professionals' experiences

Understanding frailty: meanings and beliefs about screening and prevention across key stakeholder groups in Europe

Patient Frailty: Key Considerations, Definitions and Practical Implications

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