Management of frailty: opportunities, challenges, and future directions

被引:785
|
作者
Dent, Elsa [1 ,2 ]
Martin, Finbarr C. [3 ]
Bergman, Howard [4 ]
Woo, Jean [5 ]
Romero-Ortuno, Roman [6 ,7 ,8 ]
Walston, Jeremy D. [9 ]
机构
[1] Torrens Univ Australia, Adelaide, SA, Australia
[2] Baker Heart & Diabet Inst, Melbourne, Vic, Australia
[3] Kings Coll London, Populat Hlth Sci, London, England
[4] McGill Univ, Dept Family Med, Montreal, PQ, Canada
[5] Chinese Univ Hong Kong, Dept Med, Hong Kong, Peoples R China
[6] Trinity Coll Dublin, Discipline Med Gerontol, Dublin, Ireland
[7] Trinity Coll Dublin, Global Brain Hlth Inst, Dublin, Ireland
[8] St James Hosp, Mercers Inst Successful Ageing, Dublin, Ireland
[9] Johns Hopkins Sch Med, Div Geriatr Med & Gerontol, Baltimore, MD USA
来源
LANCET | 2019年 / 394卷 / 10206期
基金
英国医学研究理事会;
关键词
COMPREHENSIVE GERIATRIC ASSESSMENT; PRIMARY-HEALTH-CARE; OLDER-PEOPLE; FUNCTIONAL DECLINE; PRACTICE GUIDELINES; CLINICAL-PRACTICE; SCREENING TOOLS; MORTALITY; ADULTS; INTERVENTIONS;
D O I
10.1016/S0140-6736(19)31785-4
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Frailty is a complex age-related clinical condition characterised by a decline in physiological capacity across several organ systems, with a resultant increased susceptibility to stressors. Because of the heterogeneity of frailty in clinical presentation, it is important to have effective strategies for the delivery of care that range across the continuum of frailty severity. In clinical practice, we should do what works, starting with frailty screening, case identification, and management of frailty. This process is unarguably difficult given the absence of an adequate evidence base for individual and health-system interventions to manage frailty. We advocate change towards individually tailored interventions that preserve an individual's independence, physical function, and cognition. This change can be addressed by promoting the recognition of frailty, furthering advancements in evidence-based treatment options, and identifying cost-effective care delivery strategies.
引用
收藏
页码:1376 / 1386
页数:11
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