Physical Frailty: ICFSR International Clinical Practice Guidelines for Identification and Management

E Dent, J E Morley, A J Cruz-Jentoft, L Woodhouse, L Rodríguez-Mañas, L P Fried, J Woo, I Aprahamian, A Sanford, J Lundy, F Landi, J Beilby, F C Martin, J M Bauer, L Ferrucci, R A Merchant, B Dong, H Arai, E O Hoogendijk, C W Won, A Abbatecola, T Cederholm, T Strandberg, L M Gutiérrez Robledo, L Flicker, S Bhasin, M Aubertin-Leheudre, H A Bischoff-Ferrari, J M Guralnik, J Muscedere, M Pahor, J Ruiz, A M Negm, J Y Reginster, D L Waters, B Vellas, E Dent, J E Morley, A J Cruz-Jentoft, L Woodhouse, L Rodríguez-Mañas, L P Fried, J Woo, I Aprahamian, A Sanford, J Lundy, F Landi, J Beilby, F C Martin, J M Bauer, L Ferrucci, R A Merchant, B Dong, H Arai, E O Hoogendijk, C W Won, A Abbatecola, T Cederholm, T Strandberg, L M Gutiérrez Robledo, L Flicker, S Bhasin, M Aubertin-Leheudre, H A Bischoff-Ferrari, J M Guralnik, J Muscedere, M Pahor, J Ruiz, A M Negm, J Y Reginster, D L Waters, B Vellas

Abstract

Objective: The task force of the International Conference of Frailty and Sarcopenia Research (ICFSR) developed these clinical practice guidelines to overview the current evidence-base and to provide recommendations for the identification and management of frailty in older adults.

Methods: These recommendations were formed using the GRADE approach, which ranked the strength and certainty (quality) of the supporting evidence behind each recommendation. Where the evidence-base was limited or of low quality, Consensus Based Recommendations (CBRs) were formulated. The recommendations focus on the clinical and practical aspects of care for older people with frailty, and promote person-centred care. Recommendations for Screening and Assessment: The task force recommends that health practitioners case identify/screen all older adults for frailty using a validated instrument suitable for the specific setting or context (strong recommendation). Ideally, the screening instrument should exclude disability as part of the screening process. For individuals screened as positive for frailty, a more comprehensive clinical assessment should be performed to identify signs and underlying mechanisms of frailty (strong recommendation). Recommendations for Management: A comprehensive care plan for frailty should address polypharmacy (whether rational or nonrational), the management of sarcopenia, the treatable causes of weight loss, and the causes of exhaustion (depression, anaemia, hypotension, hypothyroidism, and B12 deficiency) (strong recommendation). All persons with frailty should receive social support as needed to address unmet needs and encourage adherence to a comprehensive care plan (strong recommendation). First-line therapy for the management of frailty should include a multi-component physical activity programme with a resistance-based training component (strong recommendation). Protein/caloric supplementation is recommended when weight loss or undernutrition are present (conditional recommendation). No recommendation was given for systematic additional therapies such as cognitive therapy, problem-solving therapy, vitamin D supplementation, and hormone-based treatment. Pharmacological treatment as presently available is not recommended therapy for the treatment of frailty.

Keywords: 80 and over; Aged; Frailty/diagnosis; Frailty/therapy; Patient Care Planning/standards; Practice guideline.

Conflict of interest statement

E. Dent, J.E. Morley, A.J. Cruz-Jentoft, L. Rodríguez-Mañas, L.P. Fried, J. Woo, I. Aprahamian, A. Sanford, J. Lundy, J. Beilby, F.C. Martin, L. Ferrucci, R.A. Merchant, H. Arai, E.O. Hoogendijk, C.W. Won, A. Abbatecola, T. Cederholm, T. Strandberg, L.M. Gutiérrez Robledo, L. Flicker, M. Aubertin-Leheudre, H.A. Bischoff-Ferrari, J.M. Guralnik, J. Muscedere, M. Pahor, A.M. Negm, D.L. Waters declare there are no conflicts. L. Woodhouse reports personal fees from American Physical Therapy Association (APTA), personal fees from Focus on Therapeutic Outcomes (FOTO) Inc., personal fees from Canadian Physiotherapy Association (CPA), personal fees from Eli Lilly, personal fees from Scholar Rock, outside the submitted work. J.M. Bauer reports personal fees from Fresenius, personal fees from Nestlé, personal fees from Novartis, personal fees from Pfizer, personal fees from Bayer, grants and personal fees from Nutricia DANONE, outside the submitted work. J Ruiz: employees Longeveron. S. Bhasin reports grants from AbbVie, grants from Alivegen, grants from MIB, other from FPT, other from AbbVie, outside the submitted work. J.Y. Reginster reports grants and personal fees from IBSA-GENEVRIER, grants and personal fees from MYLAN, grants and personal fees from RADIUS HEALTH, personal fees from PIERRE FABRE, grants from CNIEL, personal fees from DAIRY RESEARCH COUNCIL (DRC), outside the submitted work. B. Vellas reports grants from Nestle, Nutricia, Novartis outside the submitted work.

Figures

Figure 1
Figure 1
The cascade of functional decline in older adults from independence, through to frailty and disability (in the absence of intervention) [Based on concepts and findings by Dapp et al. (34) Hoogendijk et al. (35), Clegg et al. (36) and Fried et al. (37)]

References

    1. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924–6.
    1. Hoogendijk EO, Muntinga ME, van Leeuwen KM, van der Horst HE, Deeg DJ, Frijters DH, et al. Self-perceived met and unmet care needs of frail older adults in primary care. Arch Gerontol Geriatr. 2014;58(1):37–42.
    1. Chode S, Malmstrom TK, Miller DK, Morley JE. Frailty, Diabetes, and Mortality in Middle-Aged African Americans. J Nutr Health Aging. 2016;20(8):854–9.
    1. Vermeiren S, Vella-Azzopardi R, Beckwee D, Habbig AK, Scafoglieri A, Jansen B, et al. Frailty and the Prediction of Negative Health Outcomes: A Meta-Analysis. J Am Med Dir Assoc. 2016;17(12):1163.e1–.e17.
    1. Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013;14(6):392–7.
    1. Hoogendijk EO, Rockwood K, Theou O, Armstrong JJ, Onwuteaka-Philipsen BD, Deeg DJH, et al. Tracking changes in frailty throughout later life: results from a 17-year longitudinal study in the Netherlands. Age Ageing. 2018;47(5):727–33.
    1. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381(9868):752–62.
    1. Strandberg TE, Stenholm S, Strandberg AY, et al. The “obesity paradox”, frailty, disability, and mortality in older men: A prospective, longitudinal cohort study. Am J Epidemiol. 2013;178:1452–1460.
    1. Stenholm S, Strandberg TE, Pitkala K, et al. Midlife obesity and risk of frailty in old age during a 22-year follow-up in men and woen: The Mini-Finland follow-up survey. J Gerontol A Biol Sci Med Sci. 2014;69:73–78.
    1. Savela SL, Koistinen P, Stenholm S, et al. Leisure-tme physical activity in midlife is related to old age frailty. J Gerontol A Biol Sci Med Sci. 2013;68:1433–1438.
    1. Strandberg TE, Sirola J, Pitkala KH, et al. Association of midlife obesity and cardiovascular risk with old age frailty: A 26-year follow-up of initially healthy men. Int J Obes (Lond) 2012;36:1153–1157.
    1. Atkins JL, Delgado J, Pilling LC, et al. Impact of low cardiovascular risk profiles on geriatric outcomes: Evidence from 421,000 participants in two cohorts. J Gerontol A Biol Sci Med Sci. 2019;74:350–335.
    1. Huohvanainen E, Strandberg AY, Stenholm S, et al. Association of self-rated health in midlife with mortality and old age frailty: A 26-year follow-up of initially healthy men. J Gerontol A Biol Sci Med Sci. 2016;71:923–928.
    1. Strandberg AY, Trygg T, Pitkala KH, Strandberg TE. Alzohol consumption in midlife and old age and risk of frailty: Alcohol paradox in a 30-year follow-up study. Age Ageing. 2018;47:248–254.
    1. O’Caoimh R, Galluzzo L, Rodriguez-Laso A, Van der Heyden J, Ranhoff AH, Lamprini-Koula M, et al. Prevalence of frailty at population level in European ADVANTAGE Joint Action Member States: a systematic review and meta-analysis. Ann Ist Super Sanita. 2018;54(3):226–38.
    1. Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc. 2012;60(8):1487–92.
    1. Feng Z, Lugtenberg M, Franse C, Fang X, Hu S, Jin C, et al. Risk factors and protective factors associated with incident or increase of frailty among community-dwelling older adults: A systematic review of longitudinal studies. PLoS One. 2017;12(6):e0178383.
    1. Hoogendijk EO, Rijnhart JJM, Kowal P, Perez-Zepeda MU, Cesari M, Abizanda P, et al. Socioeconomic inequalities in frailty among older adults in six low- and middle-income countries: Results from the WHO Study on global AGEing and adult health (SAGE) Maturitas. 2018;115:56–63.
    1. Hoogendijk EO, van Hout HP, Heymans MW, van der Horst HE, Frijters DH, Broese van Groenou MI, et al. Explaining the association between educational level and frailty in older adults: results from a 13-year longitudinal study in the Netherlands. Ann Epidemiol. 2014;24(7):538–44.e2.
    1. Bandeen-Roche K, Seplaki CL, Huang J, Buta B, Kalyani RR, Varadhan R, et al. Frailty in Older Adults: A Nationally Representative Profile in the United States. J Gerontol A Biol Sci Med Sci. 2015;70(11):1427–34.
    1. Crow RS, Lohman MC, Titus AJ, Cook SB, Bruce ML, Mackenzie TA, et al. Association of Obesity and Frailty in Older Adults: NHANES 1999–2004. J Nutr, Health & Aging. 2019;23(2):138–44.
    1. He B, Ma Y, Wang C, Jiang M, Geng C, Chang X, et al. Prevalence and Risk Factors for Frailty Among Community-Dwelling Older People in China: A Systematic Review and Meta-Analysis. J Nutr, Health & Aging. 2019.
    1. Dent E, Dal Grande E, Price K, Taylor AW. Frailty and usage of health care systems: Results from the South Australian Monitoring and Surveillance System (SAMSS) Maturitas. 2017;104:36–43.
    1. Lee JS, Auyeung TW, Leung J, Kwok T, Woo J. Transitions in frailty states among community-living older adults and their associated factors. J Am Med Dir Assoc. 2014;15(4):281–6.
    1. Yu R, Wong M, Chong KC, Chang B, Lum CM, Auyeung TW, et al. Trajectories of frailty among Chinese older people in Hong Kong between 2001 and 2012: an age-period-cohort analysis. Age Ageing. 2018;47(2):254–61.
    1. Marshall A, Nazroo J, Tampubolon G, Vanhoutte B. Cohort differences in the levels and trajectories of frailty among older people in England. J Epidemiol Community Health. 2015;69(4):316–21.
    1. Siriwardhana DD, Hardoon S, Rait G, et al. Prevalence of frailty and prefrailty among community-dwelling older adults in low-income and iddle-income countries: A systematic review and meta-analysis. BMJ Open. 2018;8:e018195.
    1. Rockwood K, Mitnitski A. Frailty in relation to the accumulation of deficits. J Gerontol A Biol Sci Med Sci. 2007;62(7):722–7.
    1. Gill TM, Gahbauer EA, Allore HG, Han L. Transitions between frailty states among community-living older persons. Arch Intern Med. 2006;166(4):418–23.
    1. Lang PO, Michel JP, Zekry D. Frailty syndrome: a transitional state in a dynamic process. Gerontology. 2009;55(5):539–49.
    1. Woo Jean. Designing Fit for Purpose Health and Social Services for Ageing Populations. International Journal of Environmental Research and Public Health. 2017;14(5):457.
    1. Rodriguez Manas L, Garcia-Sanchez I, Hendry A, Bernabei R, Roller-Wirnsberger R, Gabrovec B, et al. Key Messages for a Frailty Prevention and Management Policy in Europe from the ADVANTAGE JOINT ACTION Consortium. J Nutr Health Aging. 2018;22(8):892–7.
    1. Dent E, Lien C, Lim WS, Wong WC, Wong CH, Ng TP, et al. The Asia-Pacific Clinical Practice Guidelines for the Management of Frailty. J Am Med Dir Assoc. 2017;18(7):564–75.
    1. Dapp U, Minder CE, Anders J, Golgert S, von Renteln-Kruse W. Long-term prediction of changes in health status, frailty, nursing care and mortality in community-dwelling senior citizens-results from the Longitudinal Urban Cohort Ageing Study (LUCAS) BMC Geriatr. 2014;14:141.
    1. Hoogendijk EO, Romero L, Sanchez-Jurado PM, Flores Ruano T, Vina J, Rodriguez-Manas L, et al. A New Functional Classification Based on Frailty and Disability Stratifies the Risk for Mortality Among Older Adults: The FRADEA Study. J Am Med Dir Assoc. 2019;20(9):1105–1110.
    1. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013.
    1. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):146–56.
    1. Stenholm S, Ferrucci L, Vahtera J, Hoogendijk EO, Huisman M, Pentti J, et al. Natural Course of Frailty Components in People Who Develop Frailty Syndrome: Evidence From Two Cohort Studies. J Gerontol A Biol Sci Med Sci. 2019;74(5):667–674.
    1. Lewis ET, Dent E, Alkhouri H, Kellett J, Williamson M, Asha S, et al. Which frailty scale for patients admitted via Emergency Department? A cohort study. Arch Gerontol Geriatr. 2019;80:104–14.
    1. Beck AM, Dent E, Baldwin C. Nutritional intervention as part of functional rehabilitation in older people with reduced functional ability: a systematic review and meta-analysis of randomised controlled studies. J Hum Nutr Diet. 2016;29(6):733–45.
    1. Morley JE. Pathophysiology of the anorexia of aging. Curr Opin Clin Nutr Metab Care. 2013;16(1):27–32.
    1. Landi F, Picca A, Calvani R, Marzetti E. Anorexia of Aging: Assessment and Management. Clin Geriatr Med. 2017;33(3):315–23.
    1. Morley JE. Anorexia of ageing: a key component in the pathogenesis of both sarcopenia and cachexia. J Cachexia Sarcopenia Muscle. 2017;8(4):523–6.
    1. Morley JE. Anorexia, weight loss, and frailty. J Am Med Dir Assoc. 2010;11(4):225–8.
    1. Cruz-Jentoft A, Bahat G, Bauer JM, Boirie Y, Bruyere O, T. C, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2018;[accepted for publication].
    1. Morley JE, Baumgartner RN, Roubenoff R, Mayer J, Nair KS. Sarcopenia. J Lab Clin Med. 2001;137(4):231–43.
    1. Morley JE, von Haehling S, Anker SD, Vellas B. From sarcopenia to frailty: a road less traveled. J Cachexia Sarcopenia Muscle. 2014;5(1):5–8.
    1. Cruz-Jentoft AJ, Michel JP. Sarcopenia: A useful paradigm for physical frailty. European Geriatric Medicine. 2013;4(2):102–5.
    1. Dent E, Morley JE, Cruz-Jentoft AJ, Arai H, Kritchevsky SB, Guralnik J, et al. International Clinical Practice Guidelines for Sarcopenia (ICFSR): Screening, Diagnosis and Management. J Nutr, Health & Aging. 2018 DOI: 10.1007/s/12603-018-1139-9.
    1. Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004;59(3):255–63.
    1. Rodriguez-Manas L, Feart C, Mann G, Vina J, Chatterji S, Chodzko-Zajko W, et al. Searching for an operational definition of frailty: a Delphi method based consensus statement: the frailty operative definition-consensus conference project. J Gerontol A Biol Sci Med Sci. 2013;68(1):62–7.
    1. Gill TM, Gahbauer EA, Han L, Allore HG. The relationship between intervening hospitalizations and transitions between frailty states. J Gerontol A Biol Sci Med Sci. 2011;66(11):1238–43.
    1. Morley JE, Bauer JM. Nutrition and aging successfully. Current Opinion in Clinical Nutrition & Metabolic Care. 2017;20(1):1–3.
    1. Cruz-Jentoft AJ, Woo J. Nutritional interventions to prevent and treat frailty. Curr Opin Clin Nutr Metab Care. 2019;22(3):191–5.
    1. Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique. J Adv Nurs. 2000;32(4):1008–15.
    1. Frost R, Belk C, Jovicic A, Ricciardi F, Kharicha K, Gardner B, et al. Health promotion interventions for community-dwelling older people with mild or pre-frailty: a systematic review and meta-analysis. BMC Geriatr. 2017;17(1):157.
    1. Apostolo J, Cooke R, Bobrowicz-Campos E, Santana S, Marcucci M, Cano A, et al. Effectiveness of interventions to prevent pre-frailty and frailty progression in older adults: a systematic review. JBI Database System Rev Implement Rep. 2018;16(1):140–232.
    1. Lozano-Montoya I, Correa-Perez A, Abraha I, Soiza RL, Cherubini A, O’Mahony D, et al. Nonpharmacological interventions to treat physical frailty and sarcopenia in older patients: a systematic overview — the SENATOR Project ONTOP Series. Clin Interv Aging. 2017;12:721–40.
    1. de Labra C, Guimaraes-Pinheiro C, Maseda A, Lorenzo T, Millan-Calenti JC. Effects of physical exercise interventions in frail older adults: a systematic review of randomized controlled trials. BMC Geriatr. 2015;15:154.
    1. Gine-Garriga M, Roque-Figuls M, Coll-Planas L, Sitja-Rabert M, Salva A. 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(4):753–69.e3.
    1. Cadore EL, Rodriguez-Manas L, Sinclair A, Izquierdo M. Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: a systematic review. Rejuvenation Res. 2013;16(2):105–14.
    1. Gardner B, Jovicic A, Belk C, Kharicha K, Iliffe S, Manthorpe J, et al. Specifying the content of home-based health behaviour change interventions for older people with frailty or at risk of frailty: an exploratory systematic review. BMJ Open. 2017;7(2):e014127.
    1. Preston L, Chambers D, Campbell F, Cantrell A, Turner J, Goyder E. What evidence is there for the identification and management of frail older people in the emergency department? A systematic mapping review. National Institute for Health Research Journals Library. 2018; Health Services and Delivery Research, No. 6.16.
    1. Negm AM, Kennedy CC, Thabane L, Veroniki AA, Adachi JD, Richardson J, et al. Management of frailty: a protocol of a network meta-analysis of randomized controlled trials. Syst Rev. 2017;6(1):130.
    1. Cruz JE, Fahim G, Moore K. Practice Guideline Development, Grading, and Assessment. PT. 2015;40(12):854–7.
    1. Woolf S, Schunemann HJ, Eccles MP, Grimshaw JM, Shekelle P. Developing clinical practice guidelines: types of evidence and outcomes; values and economics, synthesis, grading, and presentation and deriving recommendations. Implement Sci. 2012;7:61.
    1. Alonso-Coello P, Oxman AD, Moberg J, Brignardello-Petersen R, Akl EA, Davoli M, et al. GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines. BMJ. 2016;353:i2089.
    1. Turner G, Clegg A, British Geriatrics S, Age UK, Royal College of General P. 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(6):744–7.
    1. Abbasi M, Rolfson D, Khera AS, Dabravolskaj J, Dent E, Xia L. Identification and management of frailty in the primary care setting. CMAJ. 2018;190(38):E1134–e40.
    1. van Gaans D, Dent E. Issues of accessibility to health services by older Australians: a review. Public Health Rev. 2018;39:20.
    1. Canadian Frailty Network. How screening for frailty helps. (accessed 12 July 2018).
    1. Gray WK, Richardson J, McGuire J, Dewhurst F, Elder V, Weeks J, et al. Frailty Screening in Low- and Middle-Income Countries: A Systematic Review. J Am Geriatr Soc. 2016;64(4):806–23.
    1. Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005;173(5):489–95.
    1. Morley JE, Malmstrom TK, Miller DK. A Simple Frailty Questionnaire (FRAIL) Predicts Outcomes in Middle Aged African Americans. J Nutr Health Aging. 2012;16(7):601–8.
    1. Rolfson DB, Majumdar SR, Tsuyuki RT, Tahir A, Rockwood K. Validity and reliability of the Edmonton Frail Scale. Age Ageing. 2006;35(5):526–9.
    1. Akpan A, Roberts C, Bandeen-Roche K, Batty B, Bausewein C, Bell D, et al. Standard set of health outcome measures for older persons. BMC Geriatr. 2018;18(1):36.
    1. Woo J, Yu R, Wong M, Yeung F, Wong M, Lum C. Frailty Screening in the Community Using the FRAIL Scale. J Am Med Dir Assoc. 2015;16(5):412–9.
    1. Morley JE. Rapid Geriatric Assessment: Secondary Prevention to Stop Age-Associated Disability. Clin Geriatr Med. 2017;33(3):431–40.
    1. Wyatt KAM. Frailty warning for seniors as innovative new test promises healthier ageing. 2018;22:29. . Accessed June 30, 2019.
    1. Woo J, Leung J, Morley JE. Comparison of frailty indicators based on clinical phenotype and the multiple deficit approach in predicting mortality and physical limitation. J Am Geriatr Soc. 2012;60(8):1478–86.
    1. Dent E, Kowal P, Hoogendijk EO. Frailty measurement in research and clinical practice: A review. Eur J Intern Med. 2016;31:3–10.
    1. Yang L, Jiang Y, Xu S, Bao L, Parker D, Xu X, et al. Evaluation of frailty status among older people living in urban communities by Edmonton Frail Scale in Wuhu, China: a cross-sectional study. Contemp Nurse. 2018;54(6):630–9.
    1. Hewitt J, Moug SJ, Middleton M, Chakrabarti M, Stechman MJ, McCarthy K, et al. Prevalence of frailty and its association with mortality in general surgery. Am J Surg. 2015;209(2):254–9.
    1. Kahlon S, Pederson J, Majumdar SR, Belga S, Lau D, Fradette M, et al. Association between frailty and 30-day outcomes after discharge from hospital. CMAJ. 2015;187(11):799–804.
    1. Gleason LJ, Benton EA, Alvarez-Nebreda ML, Weaver MJ, Harris MB, Javedan H. FRAIL Questionnaire Screening Tool and Short-Term Outcomes in Geriatric Fracture Patients. J Am Med Dir Assoc. 2017;18(12):1082–6.
    1. Maxwell CA, Dietrich MS, Miller RS. The FRAIL Questionnaire: A Useful Tool for Bedside Screening of Geriatric Trauma Patients. J Trauma Nurs. 2018;25(4):242–7.
    1. Basic D, Shanley C. Frailty in an older inpatient population: using the clinical frailty scale to predict patient outcomes. J Aging Health. 2015;27(4):670–85.
    1. Rajabali N, Rolfson D, Bagshaw SM. Assessment and Utility of Frailty Measures in Critical Illness, Cardiology, and Cardiac Surgery. Can J Cardiol. 2016;32(9):1157–65.
    1. Theou O, Squires E, Mallery K, Lee JS, Fay S, Goldstein J, et al. What do we know about frailty in the acute care setting? A scoping review. BMC Geriatr. 2018;18(1):139.
    1. Hogan DB, Maxwell CJ, Afilalo J, Arora RC, Bagshaw SM, Basran J, et al. A Scoping Review of Frailty and Acute Care in Middle-Aged and Older Individuals with Recommendations for Future Research. Can Geriatr J. 2017;20(1):22–37.
    1. Ambagtsheer RC, Beilby JJ, Visvanathan R, Dent E, Yu S, Braunack-Mayer AJ. Should we screen for frailty in primary care settings? A fresh perspective on the frailty evidence base: A narrative review. Prev Med. 2019;119:63–9.
    1. BGS. Is there any value in looking for frailty on a population or practice basis? (accessed 12 July 2018). 2014.
    1. Bleijenberg N, Drubbel I, Neslo RE, Schuurmans MJ, Ten Dam VH, Numans ME, et al. Cost-Effectiveness of a Proactive Primary Care Program for Frail Older People: A Cluster-Randomized Controlled Trial. J Am Med Dir Assoc. 2017;18(12):1029–36.e3.
    1. Blom JW, Van den Hout WB, Den Elzen WPJ, Drewes YM, Bleijenberg N, Fabbricotti IN, et al. Effectiveness and cost-effectiveness of proactive and multidisciplinary integrated care for older people with complex problems in general practice: an individual participant data meta-analysis. Age and Ageing. 2018;47(5):705–14.
    1. Bergman H, Ferrucci L, Guralnik J, Hogan DB, Hummel S, Karunananthan S, et al. Frailty: an emerging research and clinical paradigm—issues and controversies. J Gerontol A Biol Sci Med Sci. 2007;62(7):731–7.
    1. Ellis G, Gardner M, Tsiachristas A, Langhorne P, Burke O, Harwood RH, et al. Comprehensive geriatric assessment for older adults admitted to hospital. Cochrane Database Syst Rev. 2017;9:Cd006211.
    1. Ekdahl A.W., Sjöstrand F., Ehrenberg A., Oredsson S., Stavenow L., Wisten A., Wårdh I., Ivanoff S.D. Frailty and comprehensive geriatric assessment organized as CGA-ward or CGA-consult for older adult patients in the acute care setting: A systematic review and meta-analysis. European Geriatric Medicine. 2015;6(6):523–540.
    1. Morley JE. Frailty and Sarcopenia: The New Geriatric Giants. Rev Invest Clin. 2016;68(2):59–67.
    1. De Vriendt P, Peersman W, Florus A, Verbeke M, Van de Velde D. Improving Health Related Quality of Life and Independence in Community Dwelling Frail Older Adults through a Client-Centred and Activity-Oriented Program. A Pragmatic Randomized Controlled Trial. J Nutr Health Aging. 2016;20(1):35–40.
    1. Fairhall N, Sherrington C, Kurrle SE, Lord SR, Lockwood K, Howard K, et al. Economic evaluation of a multifactorial, interdisciplinary intervention versus usual care to reduce frailty in frail older people. J Am Med Dir Assoc. 2015;16(1):41–8.
    1. Li CM, Chen CY, Li CY, Wang WD, Wu SC. The effectiveness of a comprehensive geriatric assessment intervention program for frailty in community-dwelling older people: a randomized, controlled trial. Arch Gerontol Geriatr. 2010;50(Suppl1):S39–42.
    1. Fagard K, Leonard S, Deschodt M, Devriendt E, Wolthuis A, Prenen H, et al. The impact of frailty on postoperative outcomes in individuals aged 65 and over undergoing elective surgery for colorectal cancer: A systematic review. J Geriatr Oncol. 2016;7(6):479–91.
    1. Anker SD, Morley JE, von Haehling S. Welcome to the ICD-10 code for sarcopenia. J Cachexia Sarcopenia Muscle. 2016;7(5):512–4.
    1. Abdullahi YS, Athanasopoulos LV, Casula RP, Moscarelli M, Bagnall M, Ashrafian H, et al. Systematic review on the predictive ability of frailty assessment measures in cardiac surgery. Interact Cardiovasc Thorac Surg. 2017;24(4):619–24.
    1. Lin HS, Watts JN, Peel NM, Hubbard RE. Frailty and post-operative outcomes in older surgical patients: a systematic review. BMC Geriatr. 2016;16(1):157.
    1. Kenig J, Zychiewicz B, Olszewska U, Barczynski M, Nowak W. Six screening instruments for frailty in older patients qualified for emergency abdominal surgery. Arch Gerontol Geriatr. 2015;61(3):437–42.
    1. Li Z, Ding X. The incremental predictive value of frailty measures in elderly patients undergoing cardiac surgery: A systematic review. Clin Cardiol. 2018.
    1. Rocha V, Marmelo F, Leite-Moreira A, Moreira-Goncalves D. Clinical Utility of Frailty Scales for the Prediction of Postoperative Complications: Systematic Review and Meta-Analysis. Rev Port Cir Cardiotorac Vasc. 2017;24(3–4):132.
    1. Hamaker ME, Jonker JM, de Rooij SE, Vos AG, Smorenburg CH, van Munster BC. Frailty screening methods for predicting outcome of a comprehensive geriatric assessment in elderly patients with cancer: a systematic review. Lancet Oncol. 2012;13(10):e437–44.
    1. Palmer K, Villani ER, Vetrano DL, Cherubini A, Cruz-Jentoft AJ, Curtin D, et al. Association of polypharmacy and hyperpolypharmacy with frailty states: a systematic review and meta-analysis. European Geriatric Medicine. 2019;10(1):9–36.
    1. Page AT, Etherton-Beer CD, Clifford RM, Burrows S, Eames M, Potter K. Deprescribing in frail older people—Do doctors and pharmacists agree? Res Social Adm Pharm. 2016;12(3):438–49.
    1. Gallagher P, Ryan C, Byrne S, Kennedy J, O’Mahony D. STOPP (Screening Tool of Older Person’s Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation. Int J Clin Pharmacol Ther. 2008;46(2):72–83.
    1. Hamilton H, Gallagher P, Ryan C, Byrne S, O’Mahony D. Potentially inappropriate medications defined by STOPP criteria and the risk of adverse drug events in older hospitalized patients. Arch Intern Med. 2011;171(11):1013–9.
    1. Lavan AH, Gallagher P, Parsons C, O’Mahony D. STOPPFrail (Screening Tool of Older Persons Prescriptions in Frail adults with limited life expectancy): consensus validation. Age Ageing. 2017;46(4):600–7.
    1. O’Mahony D, O’Sullivan D, Byrne S, O’Connor MN, Ryan C, Gallagher P. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age Ageing. 2015;44(2):213–8.
    1. American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2015;63(11):2227–46.
    1. Hilmer SN, Gnjidic D, Le Couteur DG. Thinking through the medication list — appropriate prescribing and deprescribing in robust and frail older patients. Aust Fam Physician. 2012;41(12):924–8.
    1. Thompson W, Lundby C, Graabaek T, Nielsen DS, Ryg J, Sondergaard J, et al. Tools for Deprescribing in Frail Older Persons and Those with Limited Life Expectancy: A Systematic Review. J Am Geriatr Soc. 2019;67(1):172–80.
    1. Potter K, Flicker L, Page A, Etherton-Beer C. Deprescribing in Frail Older People: A Randomised Controlled Trial. PLoS One. 2016;11(3):e0149984.
    1. Morley JE. F3ALLS Approach to Preventing Falls. J Nutr, Health & Aging. 2018;22(7):748–50.
    1. Friedman SM, Shah K, Hall WJ. Failing to Focus on Healthy Aging: A Frailty of Our Discipline? J Am Geriatr Soc. 2015;63(7):1459–62.
    1. Veninsek G, Gabrovec B. Management of Frailty at Individual Level — Clinical Management: Systematic Literature Review. Zdr Varst. 2018;57(2):106–15.
    1. Kim H, Suzuki T, Kim M, Kojima N, Ota N, Shimotoyodome A, et al. Effects of exercise and milk fat globule membrane (MFGM) supplementation on body composition, physical function, and hematological parameters in community-dwelling frail Japanese women: a randomized double blind, placebo-controlled, follow-up trial. PLoS One. 2015;10(2):e0116256.
    1. Theou O, Stathokostas L, Roland KP, Jakobi JM, Patterson C, Vandervoort AA, et al. The effectiveness of exercise interventions for the management of frailty: a systematic review. J Aging Res. 2011;2011:569194.
    1. Daniels R, van Rossum E, de Witte L, Kempen GI, van den Heuvel W. Interventions to prevent disability in frail community-dwelling elderly: a systematic review. BMC Health Serv Res. 2008;8:278.
    1. Verlaan S, Ligthart-Melis GC, Wijers SLJ, Cederholm T, Maier AB, de van der Schueren MAE. High Prevalence of Physical Frailty Among Community-Dwelling Malnourished Older Adults-A Systematic Review and Meta-Analysis. Journal of the American Medical Directors Association. 2017;18(5):374–82.
    1. Lorenzo-López L, Maseda A, de Labra C, Regueiro-Folgueira L, Rodríguez-Villamil JL, Millán-Calenti JC. Nutritional determinants of frailty in older adults: A systematic review. BMC Geriatrics. 2017;17(1):108.
    1. Cederholm T, Jensen GL, Correia M, Gonzalez MC, Fukushima R, Higashiguchi T, et al. GLIM criteria for the diagnosis of malnutrition — A consensus report from the global clinical nutrition community. Clin Nutr. 2019;38(1):1–9.
    1. Ng TP, Feng L, Nyunt MS, Feng L, Niti M, Tan BY, et al. Nutritional, Physical, Cognitive, and Combination Interventions and Frailty Reversal Among Older Adults: A Randomized Controlled Trial. Am J Med. 2015;128(11):1225–36.e1.
    1. Kim CO, Lee KR. Preventive effect of protein-energy supplementation on the functional decline of frail older adults with low socioeconomic status: a community-based randomized controlled study. J Gerontol A Biol Sci Med Sci. 2013;68(3):309–16.
    1. Dent E, Hoogendijk EO, Wright ORL. New insights into the anorexia of ageing: from prevention to treatment. Curr Opin Clin Nutr Metab Care. 2019;22(1):44–51.
    1. Talegawkar SA, Bandinelli S, Bandeen-Roche K, Chen P, Milaneschi Y, Tanaka T, et al. A higher adherence to a Mediterranean-style diet is inversely associated with the development of frailty in community-dwelling elderly men and women. J Nutr. 2012;142(12):2161–6.
    1. Leon-Munoz LM, Guallar-Castillon P, Lopez-Garcia E, Rodriguez-Artalejo F. Mediterranean diet and risk of frailty in community-dwelling older adults. J Am Med Dir Assoc. 2014;15(12):899–903.
    1. Bollwein J, Diekmann R, Kaiser MJ, Bauer JM, Uter W, Sieber CC, et al. Dietary quality is related to frailty in community-dwelling older adults. J Gerontol A Biol Sci Med Sci. 2013;68(4):483–9.
    1. Kojima G, Avgerinou C, Iliffe S, Walters K. Adherence to Mediterranean Diet Reduces Incident Frailty Risk: Systematic Review and Meta-Analysis. Journal of the American Geriatrics Society. 2018;66(4):783–8.
    1. Lorenzo-Lopez L, Maseda A, de Labra C, Regueiro-Folgueira L, Rodriguez-Villamil JL, Millan-Calenti JC. Nutritional determinants of frailty in older adults: A systematic review. BMC Geriatr. 2017;17(1):108.
    1. Morley JE. Undernutrition in older adults. Fam Pract. 2012;29(Suppl1):i89–i93.
    1. Morley JE. Editorial: Defining Undernutrition (Malnutrition) in Older Persons. J Nutr Health Aging. 2018;22(3):308–10.
    1. Fairhall N. Physical, nutritional, cognitive and combination interventions reduce frailty in community-dwelling prefrail and frail older people. Evid Based Med. 2016;21(4):142.
    1. Bonnefoy M, Boutitie F, Mercier C, Gueyffier F, Carre C, Guetemme G, et al. Efficacy of a home-based intervention programme on the physical activity level and functional ability of older people using domestic services: a randomised study. J Nutr Health Aging. 2012;16(4):370–7.
    1. Kossioni AE, Hajto-Bryk J, Janssens B, Maggi S, Marchini L, McKenna G, et al. Practical Guidelines for Physicians in Promoting Oral Health in Frail Older Adults. Journal of the American Medical Directors Association. 2018;19(12):1039–46.
    1. Torres LH, Tellez M, Hilgert JB, Hugo FN, de Sousa MD, Ismail AI. Frailty, Frailty Components, and Oral Health: A Systematic Review. J Am Geriatr Soc. 2015;63(12):2555–62.
    1. Hakeem FF, Bernabe E, Sabbah W. Association between oral health and frailty: A systematic review of longitudinal studies. Gerodontology. 2019.
    1. Watanabe Y, Hirano H, Arai H, Morishita S, Ohara Y, Edahiro A, et al. Relationship Between Frailty and Oral Function in Community-Dwelling Elderly Adults. J Am Geriatr Soc. 2017;65(1):66–76.
    1. Iwasaki M, Yoshihara A, Sato N, Sato M, Minagawa K, Shimada M, et al. A 5-year longitudinal study of association of maximum bite force with development of frailty in community-dwelling older adults. J Oral Rehabil. 2018;45(1):17–24.
    1. Horibe Y, Ueda T, Watanabe Y, Motokawa K, Edahiro A, Hirano H, et al. A 2-year longitudinal study of the relationship between masticatory function and progression to frailty or pre-frailty among community-dwelling Japanese aged 65 and older. J Oral Rehabil. 2018;45(11):864–70.
    1. Ramsay SE, Papachristou E, Watt RG, Tsakos G, Lennon LT, Papacosta AO, et al. Influence of Poor Oral Health on Physical Frailty: A Population-Based Cohort Study of Older British Men. J Am Geriatr Soc. 2018;66(3):473–9.
    1. Pahor M, Kritchevsky SB, Waters DL, Villareal DT, Morley J, Hare JM, et al. Designing Drug Trials for Frailty: ICFSR Task Force 2018. J Frailty Aging. 2018;7(3):150–4.
    1. Cesari M, Fielding R, Benichou O, Bernabei R, Bhasin S, Guralnik JM, et al. Pharmacological interventions in frailty and sarcopenia: report by the international conference on frailty and sarcopenia research task force. J Frailty Aging. 2015;4(3):114–20.
    1. Annweiler C, Schott AM, Berrut G, Fantino B, Beauchet O. Vitamin D-related changes in physical performance: a systematic review. J Nutr Health Aging. 2009;13(10):893–8.
    1. Dix CF, Robinson A, Bauer JD, Wright ORL. Vitamin D: Australian dietitian’s knowledge and practices. Nutr Diet. 2017;74(4):396–407.
    1. Morley JE, Malmstrom TK. Frailty, sarcopenia, and hormones. Endocrinol Metab Clin North Am. 2013;42(2):391–405.
    1. Ju SY, Lee JY, Kim DH. Low 25-hydroxyvitamin D levels and the risk of frailty syndrome: a systematic review and dose-response meta-analysis. BMC Geriatr. 2018;18(1):206.
    1. Rejnmark L, Avenell A, Masud T, Anderson F, Meyer HE, Sanders KM, et al. Vitamin D with calcium reduces mortality: patient level pooled analysis of 70,528 patients from eight major vitamin D trials. J Clin Endocrinol Metab. 2012;97(8):2670–81.
    1. Rosendahl-Riise H, Spielau U, Ranhoff AH, Gudbrandsen OA, Dierkes J. Vitamin D supplementation and its influence on muscle strength and mobility in community-dwelling older persons: a systematic review and meta-analysis. J Hum Nutr Diet. 2017;30(1):3–15.
    1. Muir SW, Montero-Odasso M. Effect of vitamin D supplementation on muscle strength, gait and balance in older adults: a systematic review and meta-analysis. J Am Geriatr Soc. 2011;59(12):2291–300.
    1. Chan R, Chan D, Woo J, Ohlsson C, Mellstrom D, Kwok T, et al. Not all elderly people benefit from vitamin D supplementation with respect to physical function: results from the Osteoporotic Fractures in Men Study, Hong Kong. J Am Geriatr Soc. 2012;60(2):290–5.
    1. Antoniak AE, Greig CA. The effect of combined resistance exercise training and vitamin D3 supplementation on musculoskeletal health and function in older adults: a systematic review and meta-analysis. BMJ Open. 2017;7(7):e014619.
    1. Cameron ID, Dyer SM, Panagoda CE, Murray GR, Hill KD, Cumming RG, et al. Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database Syst Rev. 2018;9:Cd005465.
    1. Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB, Orav JE, Stuck AE, Theiler R, et al. Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials. BMJ. 2009;339(1):339.
    1. Bischoff-Ferrari HA, Dawson-Hughes B, Orav EJ, Staehelin HB, Meyer OW, Theiler R, et al. Monthly High-Dose Vitamin D Treatment for the Prevention of Functional Decline: A Randomized Clinical Trial. JAMA Intern Med. 2016;176(2):175–83.
    1. Ginde AA, Blatchford P, Breese K, Zarrabi L, Linnebur SA, Wallace JI, et al. High-Dose Monthly Vitamin D for Prevention of Acute Respiratory Infection in Older Long-Term Care Residents: A Randomized Clinical Trial. J Am Geriatr Soc. 2017;65(3):496–503.
    1. Smith H, Anderson F, Raphael H, Maslin P, Crozier S, Cooper C. Effect of annual intramuscular vitamin D on fracture risk in elderly men and women— a population-based, randomized, double-blind, placebo-controlled trial. Rheumatology (Oxford). 2007;46(12):1852–7.
    1. Sanders KM, Stuart AL, Williamson EJ, Simpson JA, Kotowicz MA, Young D, et al. Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial. JAMA. 2010;303(18):1815–22.
    1. Chan DC, Tsou HH, Yang RS, Tsauo JY, Chen CY, Hsiung CA, et al. A pilot randomized controlled trial to improve geriatric frailty. BMC Geriatr. 2012;12:58.
    1. Looman WM, Huijsman R, Fabbricotti IN. The (cost-)effectiveness of preventive, integrated care for community-dwelling frail older people: A systematic review. Health Soc Care Community. 2018.
    1. Gale CR, Westbury L, Cooper C. Social isolation and loneliness as risk factors for the progression of frailty: the English Longitudinal Study of Ageing. Age Ageing. 2018;47(3):392–7.
    1. Bunt S, Steverink N, Olthof J, van der Schans CP, Hobbelen JSM. Social frailty in older adults: a scoping review. Eur J Ageing. 2017;14(3):323–34.
    1. Muntinga ME, Hoogendijk EO, van Leeuwen KM, van Hout HP, Twisk JW, van der Horst HE, et al. Implementing the chronic care model for frail older adults in the Netherlands: study protocol of ACT (frail older adults: care in transition) BMC Geriatr. 2012;12:19.
    1. Luger E, Dorner TE, Haider S, Kapan A, Lackinger C, Schindler K. Effects of a Home-Based and Volunteer-Administered Physical Training, Nutritional, and Social Support Program on Malnutrition and Frailty in Older Persons: A Randomized Controlled Trial. J Am Med Dir Assoc. 2016;17(7):671.e9–.e16.
    1. Walters K, Frost R, Kharicha K, Avgerinou C, Gardner B, Ricciardi F, et al. Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT. Health Technol Assess. 2017;21(73):1–128.
    1. WHO. Integrated Care for Older People: Guidelines on Community-Level Interventions to Manage Declines in Intrinsic Capacity. Geneva: World Health Organization. 2017 . Accessed June 30, 2019.
    1. Morley JE, Vellas B. Patient-Centered (P4) Medicine and the Older Person. J Am Med Dir Assoc. 2017;18(6):455–9.
    1. Cardona-Morrell M, Lewis E, Suman S, Haywood C, Williams M, Brousseau AA, et al. Recognising older frail patients near the end of life: What next? Eur J Intern Med. 2017;45:84–90.
    1. Vahdat S, Hamzehgardeshi L, Hessam S, Hamzehgardeshi Z. Patient involvement in health care decision making: a review. Iran Red Crescent Med J. 2014;16(1):e12454.
    1. Won CW, Kim S. Use of Frailty in Deciding Clinical Treatment Goals for Chronic Disease in Elderly Patients in the Community. J Am Med Dir Assoc. 2016;17(11):967–9.

Source: PubMed

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