Management of frailty at individual level – clinical management: Systematic literature review

Veninšek, Gregor; Gabrovec, Branko

doi:10.2478/sjph-2018-0014

Cited by 16 publications

(25 citation statements)

References 35 publications

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“…Similarly, there was insufficient literature to determine the exact combination of training modes (aerobic, resistance and balance training) most effective for frailty management. Notwithstanding this, it is understood that for physical activity programs to be effective for those with frailty, a minimal level of intensity and an adequate program timespan are needed (122). Group physical activity sessions were more likely to be successful in improving frailty than individual sessions according to a recent systematic review (57), although this premise is based on only two trials which did not use qualified trainers.…”

Section: Physical Activitymentioning

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

579

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: Physical Activitymentioning

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

579

536

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“…Considering that frailty is a common feature of the elderly, it is also important to obtain information on this area. Veninšek and Gabrovec (45) identified four main areas essential for the clinical management of frailty: definition of frailty, epidemiology of frailty, tools for screening and diagnosis frailty and successful interventions for decreasing frailty. The priority objective of the WHO Global Strategy and Action Plan on Aging and Health (13) to fill information gaps at the global level is thus well grounded.…”

Section: Discussionmentioning

confidence: 99%

Frailty assessment scales for the elderly and their application in primary care: A systematic literature review

Dolenc

Rotar-Pavlič

2019

Slovenian Journal of Public Health

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Background The increase in the elderly population is causing changes and challenges that demand a comprehensive public health response. A specific characteristic of the elderly is their frailty. Today’s problems with identifying levels of frailty are being resolved by numerous tools in the form of frailty assessment scales. This systematic review establishes which frailty assessment scales for the elderly are being used and what their applicability in primary care is like in Slovenia and around the world. Methods Documents published after 2010 were searched for in the PubMed database using keywords and other specific criteria. Results A total of 177 search hits were obtained based on various search strings. The final analysis included 28 articles, of which three were systematic literature reviews. These three covered quantitative studies, mainly consisting of observational cross-sectional surveys or cohort studies. Three other studies featured non-systematic literature reviews. Quantitative studies (mainly cross-sectional surveys or cohort studies) prevailed among the remaining 22 articles. One study had a qualitative design (Delphi method). The main outcome measures observed by all studies were frailty assessment scales for the elderly, the majority of which were evaluated on a sample of the elderly. Conclusions None of the assessment scales examined are used as the gold standard for primary care. A variety of tools are being used in clinical practice to assess frailty in elderly patients, highlighting the need for standardization and guidelines. This requires evaluating the current assessment scales in terms of validity and reliability, and suitably improving them.

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“…There are several frailty measures (Frailty Phenotype/ FP, Groningen Frailty Indicator/GFI and Tilburg Frailty Indicator/TFI) and each frailty measure classified a different group of individuals as frail (Metzelthin, et al, 2010;Theou, et al, 2013;Malmstrom, et al, 2014). To tackle frailty it is important to know the risk factors for frailty, as suggested in the research conducted by Veninšek and Gabrovec (2018). The potential causes are wider and include multiple risk factors which are implicated in various diseases and conditions (British Geriatrics Society, 2014).…”

Section: Discussionmentioning

confidence: 99%

Management of frailty at individual level – Frailty prevention

Skela-Savič

Gabrovec

2018

Obzor Zdrav Neg

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Introduction: Frailty is a geriatric syndrome characterized by a diminished physiological reserve of multiple organs, which means increased of vulnerability of older people to adverse outcomes. As the process which leads to frailty can be decelerated or even completely reversed, early prevention interventions are crucial. Methodology: A systematic literature search was conducted in the following databases: PubMed, Cochrane, Embase, Cinahl and UpToDate. The criterion in selecting the literature was that articles were published from 2002 to 2017. From 391.910 initial hits, 31 publications were selected. Results: Early diagnosis of frailty and functional decline are considered effective measures against age-related comorbidities. Targeted interventions have a significant impact on preventing the progression of frailty and the negative consequences of frailty. Lifestyle, including physical activity (particularly resistance exercise) and nutrition (higher protein intake and vitamin D supplement), is a good measure for preventing disorders associated with age. Conclusion: Targeted interventions have a significant modifiable influence on preventing frailty. Frailty management and early interventions comprise comprehensive and multidisciplinary approach including clinical management with physical management, nutrition and drugs.

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Management of frailty at individual level – clinical management: Systematic literature review

Cited by 16 publications

References 35 publications

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

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

Frailty assessment scales for the elderly and their application in primary care: A systematic literature review

Management of frailty at individual level – Frailty prevention

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