Need for comprehensive management of frailty at an individual level: European perspective from the advantage joint action on frailty

Abstract

ADVANTAGE Joint Action is a project co-founded by the European Commission and the Member States, with the aim of building a common understanding of frailty on which to base an approach for older people who are frail or at risk. Based on a systematic review of the literature, including grey literature and good practice, where possible, this paper proposes some key interventions to tackle frailty. Prevention should be based on a multifaceted approach, addressing factors that have resonance across the individual's life course. All older people (over 70 years of age) should be offered a screening test and, if positive, referred for diagnosis. The management of frailty must be based on comprehensive geriatric assessment, to enable effective planning. Multicomponent exercise programmes, adequate protein and vitamin D intake, when insufficient, as well as reduction in poly pharmacy and inadequate prescription are the most effective strategies to manage frailty. Objectives: ADVANTAGE Joint Action is a large collaborative project co-founded by the European Commission and its Member States to build a common understanding of frailty for Member States on which to base a common management approach for older people who are frail or at risk of developing frailty. One of the key objectives of the project is presented in this paper; how to manage frailty at the individual level. Methods: A systematic review of the literature was conducted, including grey literature and good practices when possible. Results: The management of frailty should be directed towards comprehensive and holistic treatment in multiple and related fields. Prevention requires a multifaceted approach addressing factors that have resonance across the individual's life course. Comprehensive geriatric assessment to diagnose the condition and plan a personalized multidomain treat ment improves outcomes. Multicomponent exercise programmes, adequate protein and vitamin D intake, when insufficient, and reduction in polypharmacy and inadequate prescription, are the most effective strategies found in the literature to manage frailty effectively. Conclusion: Frailty can be effectively prevented and managed with a multidomain intervention strategy based on comprehensive geriatric assessment.

La experiencia europea ADVANTAGE para el manejo de la fragilidad: claves sobre su aplicabilidad en América Latina

“…A nivel internacional, los miembros de ADVANTAGE colaboraron entre sí y con diversos organismos e instituciones, como la Comisión Europea, la Sociedad Europea de Medicina Geriátrica, la Fundación Internacional de Cuidados Integrados y gran parte de las sociedades nacionales de geriatría. Estas colaboraciones dieron lugar a numerosas presentaciones en eventos y publicaciones (10)(11)(12)(13)(14)(15)(16)(17)(18)(19), que han generado un fluido intercambio, entre otras cosas, de buenas prácticas de abordaje de la fragilidad. Al día de hoy, gran parte de los miembros de ADVANTAGE siguen colaborando en el grupo de fragilidad de la Fundación Internacional de Cuidados Integrados.…”

Malnutrition in sickle cell anemia: Prevalence, impact, and interventions: A Review

“…Regular nutritional assessments, dietary counseling, and supplementation when necessary are important components of managing malnutrition in SCA. [ 36 ]…”

„Frailty“ bei nephrologischen Erkrankungen

“…Da Frailty in der Ausprägung multidimensional ist, muss auch ein therapeutischer Ansatz mehrere verschiedene Bereiche adressieren und interdisziplinär angelegt sein. Grundlage für Interventionen sollte immer eine ganzheitliche Beurteilung des Gesundheitszustandes, der Funktionalität und des sozialen Umfelds durch ein Comprehensive Geriatric Assessment sein [ 23 , 24 ]. Allgemeine Empfehlungen zu Prävention und Management von Frailty sind in der European Perspective of Joint Action on Frailty und den ICFSR International Clinical Practice Guidelines ausführlich beschrieben [ 25 , 26 ].…”