Diagnosis and Management of Frailty in Primary Health Care

Abstract

Disability in older adults has become a significant burden, both individually and socially, due to the rapidly aging population in Korea. It is important to manage both frailty and chronic diseases to delay disability. Frailty, which is considered to be a transition phase between healthy status and disability, is defined as a significant decline in functional reserves of multiple organ systems and the resultant extreme vulnerability to stressors, leading to a higher risk of adverse health-related outcomes. The frailty phenotype and frailty index are the most commonly used methods to diagnose frailty. Frailty is related to physical, psycho logical, cognitive, and social dysfunction, and is sometimes caused by chronic disease. Therefore, primary care providers are ideally situated to incorporate the concept of frailty into their practice, as they are champions in comprehensive care. Although the identification and treatment of frailty is not yet standard practice in primary care, primary care physicians must use the electronic frailty index to identify frailty in all the patients aged ≥65 years in the United Kingdom. In Canada, some insurance companies and governments are using a similar program, which is called the Community Actions and Resources Empowering Seniors model. The clinical practice guidelines of the International Conference of Frailty and Sarcopenia Research, as well as some additional references, will be introduced. Here, we review the current literature on how to diagnose and manage frailty in primary care.

World Health Organization Integrated Care for Older People (ICOPE) and the Integrated Care of Older Patients with Frailty in Primary Care (ICOOP_Frail) Study in Korea

“…The frailty index is related to physical, psychological, cognitive, sensory, and social functional declines, and the index is used not only to identify frail persons but also those at risk of frailty. 5 )…”

“…The frailty index is related to declines in physical, psychological, cognitive, sensory, and social functions and can be used to identify not only frail persons but also those at risk of frailty. 5 ) In addition, the frailty index and IC are based on the assumption that aging individuals can be adequately assessed and managed only if comprehensively evaluated and followed in a novel healthcare model based on service integration and multidisciplinarity. 2 ) Therefore, the integrated care of older patients with frailty or risk of frailty based on the frailty index is as important for achieving healthy aging as reducing frailty is for promoting healthy aging.…”

Perceived Recovery Time from Common Cold as a Possible Indicator of Physical Resilience

“…Frailty is defined as a significant decline in the functional reserve of multiple organ systems and the resultant extreme vulnerability of an individual to endogenous and exogenous stressors (such as infection, injury, surgery, or some medicines), leading to a higher risk of accelerated functional decline and adverse health-related outcomes. 1) The adverse health-related outcomes caused by frailty in-clude falls, delirium, immobility, or disability, and, consequently, hospitalizations, institutionalization, or mortality. 1) Over the past decade, resilience has increasingly become a focus of research in the behavioral and medical sciences.…”

“…1) The adverse health-related outcomes caused by frailty in-clude falls, delirium, immobility, or disability, and, consequently, hospitalizations, institutionalization, or mortality. 1) Over the past decade, resilience has increasingly become a focus of research in the behavioral and medical sciences. Frail older adults have a preexisting vulnerability to stressors, often resulting in poor outcomes.…”

“… 1 ) The adverse health-related outcomes caused by frailty include falls, delirium, immobility, or disability, and, consequently, hospitalizations, institutionalization, or mortality. 1 )…”