F3ALLS Approach to Preventing Falls

Morley, John E.

doi:10.1007/s12603-018-1046-0

Cited by 10 publications

(6 citation statements)

References 64 publications

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“…All older persons with frailty should be assessed for visual and hearing difficulties and these should be corrected when present. Those who are at risk of falling should be checked for orthostatic hypotension and syncope (120).…”

Section: Development Of a Comprehensive Management Planmentioning

confidence: 99%

Physical Frailty: ICFSR International Clinical Practice Guidelines for Identification and Management

Dent

Morley

Cruz-Jentoft

et al. 2019

The Journal of nutrition, health and aging

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583

536

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Objective: The task force of the International Conference of Frailty and Sarcopenia Research (ICFSR) developed these clinical practice guidelines to overview the current evidence-base and to provide recommendations for the identification and management of frailty in older adults. Methods: These recommendations were formed using the GRADE approach, which ranked the strength and certainty (quality) of the supporting evidence behind each recommendation. Where the evidence-base was limited or of low quality, Consensus Based Recommendations (CBRs) were formulated. The recommendations focus on the clinical and practical aspects of care for older people with frailty, and promote person-centred care. Recommendations for Screening and Assessment: The task force recommends that health practitioners case identify/screen all older adults for frailty using a validated instrument suitable for the specific setting or context (strong recommendation). Ideally, the screening instrument should exclude disability as part of the screening process. For individuals screened as positive for frailty, a more comprehensive clinical assessment should be performed to identify signs and underlying mechanisms of frailty (strong recommendation). Recommendations for Management: A comprehensive care plan for frailty should address polypharmacy (whether rational or nonrational), the management of sarcopenia, the treatable causes of weight loss, and the causes of exhaustion (depression, anaemia, hypotension, hypothyroidism, and B12 deficiency) (strong recommendation). All persons with frailty should receive social support as needed to address unmet needs and encourage adherence to a comprehensive care plan (strong recommendation). First-line therapy for the management of frailty should include a multicomponent physical activity programme with a resistance-based training component (strong recommendation). Protein/caloric supplementation is recommended when weight loss or undernutrition are present (conditional recommendation). No recommendation was given for systematic additional therapies such as cognitive therapy, problem-solving therapy, vitamin D supplementation, and hormone-based treatment. Pharmacological treatment as presently available is not recommended therapy for the treatment of frailty.

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Section: Development Of a Comprehensive Management Planmentioning

confidence: 99%

Physical Frailty: ICFSR International Clinical Practice Guidelines for Identification and Management

Dent

Morley

Cruz-Jentoft

et al. 2019

The Journal of nutrition, health and aging

Self Cite

583

536

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“…In persons at risk for hip fracture, besides strengthening the bones it is essential that physicians pay attention to fall risk. The Toulouse-St. Louis University MiniFalls test should be used (30) along with the F3ALLS treatment paradigm (31). In addition, all persons at risk for fracture should be screened for frailty -using the FRAIL -and treated with the frail algorithm (32)(33)(34)(35)(36).…”

Section: Resultsmentioning

confidence: 99%

Old Bones

Morley

2020

The Journal of nutrition, health and aging

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Bone is a dynamic organ in which osteoblasts, under inhibitory control of sclerostin, creates new bone osteoblasts by releasing RANK-L to activate osteoclasts to remove bone. This dynamic network is under local control of miRNAs and long noncoding RNAs to balance the effect of bone stressors on bone formation (1). With aging there is an increase in fragility fractures. Fractures are a more common reason for older persons requiring interaction with medical professionals than any other disease and are one of the higher components of annual hospital costs (2). Over 20% of older persons with hip fractures die within a year and they are a major cause of disability (3). Vertebral fractures are a major cause of back pain, loss of height, reduced pulmonary function, dysphagia, deformity and a decline in quality of life. The need for collaboration between orthopedic surgeons and geriatricians to improve outcomes of older persons with fractures led to the forming of the first geriatric orthopaedic unit by Bobby Irvine and Michael Devas in 1963 (4). The motto of this unit was "Bedrest is rehabilitation for the grave." Richard Lefroy published the first positive effects of a geriatric orthopedic unit in Perth, Australia (5). A meta-analysis found that these combined programs resulted in a decrease in both in-hospital and long-term mortality (6). Two recent approaches improving hip fracture care are: (i) providing regional nerve blocks on arrival at hospital to reduce pain and improve function outcomes (7) and (ii) injection of a triphasic calcium based implant (AGN-1) into the contralateral proximal femur to reduce subsequent hip fracture in the other hip (8). There are three major bone diseases in older persons-Paget's disease of bone, osteomalacia, and osteoporosis.

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“…Sarcopenia is a major cause of physical frailty and falls in older persons. As at present, there is a simple therapy—aggressive resistance exercise—when sarcopenia is detected early, it seems reasonable to screen older persons and those with diabetes for sarcopenia and frailty using the Rapid Geriatric Assessment tool and begin secondary prevention as early as possible.…”

Section: Patient‐centred Approach To Management Of Sarcopeniamentioning

confidence: 99%

Treatment of sarcopenia: the road to the future

Morley

2018

J cachexia sarcopenia muscle

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F3ALLS Approach to Preventing Falls

Cited by 10 publications

References 64 publications

Physical Frailty: ICFSR International Clinical Practice Guidelines for Identification and Management

Physical Frailty: ICFSR International Clinical Practice Guidelines for Identification and Management

Old Bones

Treatment of sarcopenia: the road to the future

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