Developing Interventions for Frailty

Abstract

Frailty is a well-recognised, complex syndrome, predominantly affecting older people. Currently, there are two main conceptualizations of frailty: the phenotypic and the accumulated deficit models, with the phenotypic model being more widely applied in clinical research. Based on these models, we contend that a number of the phenotypic frailty components (weakness, slowness, and low energy expenditure) are potentially reversible. This paper outlines the results of a frailty research program. It summarizes the initial frailty treatment model and reports its effectiveness. Briefly, the effect of a twelve-month individually tailored multifactorial, interdisciplinary intervention targeting frailty was compared with usual care. The intervention reduced phenotypically defined frailty and improved mobility. Further, it is contended that there is evidence of substantial unmet need due to treatment fragmentation and the absence of a comprehensive approach for this population. Our paper then outlines the current stage of our research in which the model is now being extended to prefrailty. Interventions aimed at reversing the frailty syndrome or its consequences are only in their early stages. There is significant scope for future research to identify optimal management programs for frail older people.

Effects of multi-domain interventions in (pre)frail elderly on frailty, functional, and cognitive status: a systematic review

“…Similarly, the persistence of the achieved effects is difficult to discuss as only five studies included follow-up measurements in their study. Third, more studies should examine the ability of the interventions to prevent or treat frailty, as considerable literature describes that multi-domain interventions have this potential 13,16. Essentially, researchers are encouraged to investigate their results from a broader perspective.…”

Care recipients’ physical frailty is independently associated with subjective burden in informal caregivers in the community setting: a cross-sectional study

“…As such, it indicates that future observational and experimental studies addressing physical frailty may benefit from including caregiver burden as a dependent variable. It also provides further support for the observation that “the inclusion of carers in trials targeting frailty may assist in the identification of at-risk carers and facilitate the provision of information and support that will assist them in their role.” [27] In addition to addressing some of the limitations discussed above, future studies might be expanded to include analysis of caregiver characteristics or consider support structures. For instance, other studies have shown that caregiver gender, competence, coping and personality traits, and health may affect burden, and that respite care may moderate caregiver burden [26, 28, 29].…”

Validation of the Mini Nutritional Assessment-Short Form in a population of frail elders without disability. Analysis of the Toulouse Frailty Platform population in 2013

“…In the former subjects, nutrition surely represents a cornerstone to maintain good functional performances and prevent poor health outcomes. Screening malnourished (or at risk of malnutrition) frail elders enables to perform a geriatric assessment, review critically their diet and offer them corrective measures and nutritional support (16). Precisely, the MNA-SF was designed to assess malnutrition is different populations of vulnerable older adults such as hospitalized patients, nursing home residents or demented subjects (9).…”