Diagnostik und Behandlung physischer Frailty

Abstract

Physical frailty is a physiological syndrome of older people. It is characterized by a reduced reserve, a reduced stressor resistance, and vulnerability to negative health outcomes. The assessment of physical frailty is increasingly applied to identify high risk patients prior to medical or surgical interventions. The present article describes Fried’s frailty phenotype, which is the most frequently applied diagnostic instrument of physical frailty, together with evidence based treatment options.

Das Frailty-Syndrom beschreibt den vulnerablen Zustand älterer Menschen für negative Gesundheitsereignisse. Im Zuge des demografischen Wandels wird die Erkennung und Behandlung von Frailty künftig eine noch wichtigere Rolle spielen. Durch geeignete Interventionen kann das Syndrom verhindert, verzögert oder behandelt werden.

Schlüsselwörter

Gebrechlichkeit - physische Frailty - Frailty Phänotyp - geriatrisches Assessment

Key words

frailty - physical frailty - frailty phenotype - geriatric assessment

• Literatur

• 1 Fried LP. Tangen CM. Walston J. et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001; 56: M146-M156
• 2 Mitnitski AB. Mogilner AJ. Rockwood K. Accumulation of Deficits as a Proxy Measure of Aging. Scient World J 2001; 1: 323-336
• 3 Rockwood K. Song X. MacKnight C. et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005; 173: 489-495
• 4 Morley JE. Vellas B. van Abellan KanG. et al. Frailty consensus: a call to action. J Am Med Dir Assoc 2013; 14: 392-397
• 5 Shamliyan T. Talley KMC. Ramakrishnan R. et al. Association of frailty with survival. Ageing Res Rev 2013; 12: 719-736
• 6 Ferrucci L. Guralnik JM. Studenski S. et al. Designing randomized, controlled trials aimed at preventing or delaying functional decline and disability in frail, older persons. J Am Geriatr Soc 2004; 52: 625-634
• 7 Kojima G. Frailty as a Predictor of Future Falls Among Community-Dwelling Older People. J Am Med Dir Assoc 2015; 16: 1027-1033
• 8 Chang SF. Lin PL. Frail phenotype and mortality prediction. Int J Nurs Stud 2015; 52: 1362-1374
• 9 Bandeen-Roche K. Xue QL. Ferrucci L. et al. Phenotype of frailty: characterization in the women's health and aging studies. J Gerontol A Biol Sci Med Sci 2006; 61: 262-266
• 10 Song X. Mitnitski A. Rockwood K. Nontraditional risk factors combine to predict Alzheimer disease and dementia. Neurology 2011; 77: 227-234
• 11 Inouye SK. Studenski S. Tinetti ME. et al. Geriatric syndromes: clinical, research, and policy implications of a core geriatric concept. J Am Geriatr Soc 2007; 55: 780-791
• 12 Collard RM. Boter H. Schoevers RA. et al. Prevalence of frailty in community-dwelling older persons. J Am Geriatr Soc 2012; 60: 1487-1492
• 13 Buttery AK. Busch MA. Gaertner B. et al. Prevalence and correlates of frailty among older adults. BMC Geriatr 2015; 15: 22
• 14 Saum KU. Muller H. Stegmaier C. et al. Development and evaluation of a modification of the Fried frailty criteria using population-independent cutpoints. J Am Geriatr Soc 2012; 60: 2110-2115
• 15 Drey M. Wehr H. Wehr G. et al. The frailty syndrome in general practitioner care. Z Gerontol Geriatr 2011; 44: 48-54
• 16 Clegg A. Young J. Iliffe S. et al. Frailty in elderly people. Lancet 2013; 381: 752-762
• 17 Cesari M. Gambassi G. van Abellan Kan G. et al. The frailty phenotype and the frailty index. Age Ageing 2014; 43: 10-12
• 18 de Vries NM. Staal JB. van Ravensberg CD. et al. Outcome instruments to measure frailty. Ageing Res Rev 2011; 10: 104-114
• 19 Walston JD. Bandeen-Roche K. Frailty: a tale of two concepts. BMC Med 2015; 13: 991
• 20 Bouillon K. Kivimaki M. Hamer M. et al. Measures of frailty in population-based studies. BMC Geriatr 2013; 13: 64
• 21 Xue QL. Varadhan R. What is missing in the validation of frailty instruments?. J Am Med Dir Assoc 2014; 15: 141-142
• 22 Roberts H. Denison H. Martin H. et al. A review of the measurement of grip strength in clinical and epidemiological studies. Age Ageing 2011; 40: 423-429
• 23 Theou O. Cann L. Blodgett J. et al. Modifications to the frailty phenotype criteria: Systematic review of the current literature and investigation of 262 frailty phenotypes in the Survey of Health, Ageing, and Retirement in Europe. Ageing Res Rev 2015; 21: 78-94
• 24 Cameron ID. Fairhall N. Langron C. et al. A multifactorial interdisciplinary intervention reduces frailty in older people: randomized trial. BMC Med 2013; 11: 65
• 25 Clegg A. Rogers L. Young J. Diagnostic test accuracy of simple instruments for identifying frailty in community-dwelling older people. Age Ageing 2015; 44: 148-152
• 26 Turner G. Clegg A. Best practice guidelines for the management of frailty: a British Geriatrics Society, Age UK and Royal College of General Practitioners report. Age Ageing 2014; 43: 744-747
• 27 Cameron ID. Kurrle SE. Frailty and Rehabilitation. In: Theou O. Rockwood K. Hrsg Frailty in aging: Biological, clinical, and social implications. Basel: Karger; 2015: 137-150
• 28 Ng TP. Feng L. Nyunt MSZ. et al. Nutritional, Physical, Cognitive, and Combination Interventions and Frailty Reversal Among Older Adults. Am J Med 2015; 128: 1225-1236
• 29 Fairhall N. Langron C. Sherrington C. et al. Treating frailty – a practical guide. BMC Med 2011; 9: 83
• 30 Theou O. Stathokostas L. Roland KP. et al. The effectiveness of exercise interventions for the management of frailty: a systematic review. J Aging Res 2011; 2011: 1-19
• 31 Stuck AE. Siu AL. Wieland GD. et al. Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet 1993; 342: 1032-1036
• 32 Fairhall N. Sherrington C. Kurrle SE. et al. Effect of a multifactorial interdisciplinary intervention on mobility-related disability in frail older people. BMC Med 2012; 10: 120
• 33 Gine-Garriga M. Roque-Figuls M. Coll-Planas L. et al. Physical exercise interventions for improving performance-based measures of physical function in community-dwelling frail older adults: a systematic review and meta-analysis. Arch Phys Med Rehabil 2014; 95: 753-769
• 34 Cesari M. Vellas B. Hsu FC. et al. A Physical Activity Intervention to Treat the Frailty Syndrome in Older Persons – Results From the LIFE-P Study. J Gerontol A Biol Sci Med Sci 2015; 70: 216-222
• 35 Chodzko-Zajko WJ. Proctor DN. Fiatarone Singh MA. et al. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc 2009; 41: 1510-1530
• 36 Weening-Dijksterhuis E. de Greef MHG. Scherder EJA. et al. Frail institutionalized older persons: A comprehensive review on physical exercise, physical fitness, activities of daily living, and quality-of-life. Am J Phys Med Rehabil 2011; 90: 156-168
• 37 Clegg A. Barber S. Young J. et al. The Home-based Older People's Exercise (HOPE) trial: a pilot randomised controlled trial of a home-based exercise intervention for older people with frailty. Age Ageing 2014; 43: 687-695
• 38 Theou O. Yu S. Rockwood K. et al. Focus on frailty: essential as the population ages. Medicine Today 2015; 16: 28-33
• 39 Calvani R. Miccheli A. Landi F. et al. Current nutritional recommendations and novel dietary strategies to manage sarcopenia. J Frailty Aging 2013; 2: 38-53
• 40 Bauer J. Biolo G. Cederholm T. et al. Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group. J Am Med Dir Assoc 2013; 14: 542-559