Frailty : Update on Diagnosis Evaluation and Management Part 2

Abstract

Life expectancy continues to rise globally. However, the additional years of life do not always correspond to years of healthy life, which may result in an increase in frailty. Given the rapid aging of the population, the association between frailty and age, and the impact of frailty on adverse outcomes for older adults, frailty is increasingly recognized as a significant public health concern. Early detection of the condition is critical for assisting older adults in regaining function and avoiding the negative consequences associated with the syndrome. Despite the critical nature of frailty diagnosis, there is no conclusive evidence or consensus regarding whether routine screening should be implemented. A variety of screening and assessment instruments have been developed from a biopsychosocial perspective, with frailty defined as a dynamic state caused by deficits in any of the physical, psychological, or social domains associated with health. All of these aspects of frailty should be identified and addressed through the use of a comprehensive and integrated approach to care. To accomplish this goal, public health and primary health care (PHC) must serve as the fulcrum around which care is delivered, not just to the elderly and frail, but to all individuals, by emphasizing a life-course and patient-centered approach centered on integrated, community-based care. Personnel in public health should be trained to address frailty not just clinically, but also in a societal context. Interventions should take place in the contextof the individuals’ eNVIRONMENT AND SOCIAL NETWORKS. ADDITIONALLY, PUBLIC HEALTH PROFESSIONALS SHOULD CONTRIBUTE TO COMMUNITY-BASED FRAILTY EDUCATION AND TRAINING, PROMOTING COMMUNITY-BASED INTERVENTIONS THAT ASSIST OLDER ADULTS AND THEIR CAREGIVERS IN PREVENTING AND MANAGING FRAILTY. THE PURPOSE OF THIS PAPER IS TO PROVIDE AN OVERVIEW OF FRAILTY FOR A PUBLIC HEALTH AUDIENCE IN ORDER TO INCREASE AWARENESS OF THE MULTIDIMENSIONAL NATURE OF FRAILTY AND HOW IT SHOULD BE ADDRESSED THROUGH AN INTEGRATED AND HOLISTIC APPROACH TO CARE. KEY WORDS: FRAILTY, DIAGNOSIS, EVALUATION, MANAGEMENT