Differences between robust, frail, prefrail and dependent institutionalized older people

Santamaría-Peláez, Mirian; González-Bernal, Jerónimo; González‐Santos, Josefa; Soto-Cámara, Raúl

doi:10.1016/j.aprim.2021.101968

Cited by 2 publications

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References 3 publications

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“…Furthermore, frailty can be influenced by many factors like comorbidity, genetic and environmental factors, and the presence of geriatric syndromes. Based on global trends in aging, we are able to classify older people into three subtypes: robust, frail, and severely disabled or dependent subjects [ 13 , 14 , 15 ] ( Figure 1 ).…”

Section: Introductionmentioning

confidence: 99%

Management of Vertebral Fragility Fracture in Older People: Recommendations from a Spanish Consensus of Experts

Castañeda,

Navarro Ceballos,

Usón Jaeger

et al. 2024

Geriatrics

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Vertebral fragility fractures (VFF) pose a challenge for appropriate care. The aim of this study was to develop consensus recommendations for the management of VFF in older people from a multidisciplinary approach. Specialists in osteoporosis belonging to different scientific societies reviewed the main clinical practice guidelines published in Spain in 2014. Thirty-five recommendations for the management of VFF were evaluated by seven experts using an anonymous survey. Consensus was defined as 80% of responses of 8 (agree) and 9 (strongly agree) on a Likert scale. Consensus was achieved in 22 recommendations (62.8%). The experts agreed on the need for anamnesis, clinical assessment, and laboratory tests, including erythrocyte sedimentation rate, proteinography, and the assessment of levels of calcium, vitamin D, alkaline phosphatase, and thyroid-stimulating hormone. Optional tests, such as bone turnover markers (BTMs), magnetic resonance imaging, bone scintigraphy, or using a fracture risk assessment tool (FRAX®), did not achieve an agreed consensus. Also, there was consensus regarding the administration of calcium/vitamin D supplements, the withdrawal of toxic habits, and personalized physical exercise. Participants agreed on the administration of teriparatide for 24 months and then a switch to denosumab or bisphosphonates in patients at high risk of fracture. Specialists in osteoporosis, primary care physicians, and geriatricians should be involved in the follow-up of patients with VFF. Although there was multidisciplinary agreement on diagnostic tests and non-pharmacological and pharmacological treatment in frail older people, therapeutic objectives should be individualized for every patient. In addition to the specific recommendations, close collaboration between the geriatrician and the primary care physician is essential for the optimal chronic management of frail patients with fragility fractures.

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Section: Introductionmentioning

confidence: 99%