Digital Health Service for Identification of Frailty Risk Factors in Community-Dwelling Older Adults: The SUNFRAIL+ Study Protocol

Vincenzo De Luca, Grazia Daniela Femminella, Lisa Leonardini, Lola Patumi, Ernesto Palummeri, Isabella Roba, Walter Aronni, Stefano Toccoli, Simona Sforzin, Fortunata Denisi, Anna Maddalena Basso, Manuela Ruatta, Paola Obbia, Alessio Rizzo, Moira Borgioli, Claudio Eccher, Riccardo Farina, Diego Conforti, Lorenzo Mercurio, Elena Salvatore, Maurizio Gentile, Marialuisa Bocchino, Alessandro Sanduzzi Zamparelli, Giulio Viceconte, Ivan Gentile, Carlo Ruosi, Nicola Ferrara, Gabriella Fabbrocini, Annamaria Colao, Maria Triassi, Guido Iaccarino, Giuseppe Liotta, Maddalena Illario, Vincenzo De Luca, Grazia Daniela Femminella, Lisa Leonardini, Lola Patumi, Ernesto Palummeri, Isabella Roba, Walter Aronni, Stefano Toccoli, Simona Sforzin, Fortunata Denisi, Anna Maddalena Basso, Manuela Ruatta, Paola Obbia, Alessio Rizzo, Moira Borgioli, Claudio Eccher, Riccardo Farina, Diego Conforti, Lorenzo Mercurio, Elena Salvatore, Maurizio Gentile, Marialuisa Bocchino, Alessandro Sanduzzi Zamparelli, Giulio Viceconte, Ivan Gentile, Carlo Ruosi, Nicola Ferrara, Gabriella Fabbrocini, Annamaria Colao, Maria Triassi, Guido Iaccarino, Giuseppe Liotta, Maddalena Illario

Abstract

This article reports the study protocol of a nationwide multicentric study in seven Italian regions aimed at assessing the effectiveness of a digitally supported approach for the early screening of frailty risk factors in community-dwelling older adults. SUNFRAIL+ is a prospective observational cohort study aimed at carrying out a multidimensional assessment of community-dwelling older adults through an IT platform, which allows to connect the items of the SUNFRAIL frailty assessment tool with a cascading multidimensional in-depth assessment of the bio-psycho-social domains of frailty. Seven centers in seven Italian regions will administer the SUNFRAIL questionnaire to 100 older adults. According to the answers provided by older adults, they will be subjected to one or more validated in-depth scale tests in order to perform further diagnostic or dimensional evaluations. The study aims to contribute to the implementation and validation of a multiprofessional and multistakeholder service model for the screening of frailty in community-dwelling older adult population.

Trial registration: ClinicalTrials.gov NCT05646472.

Keywords: active and healthy aging; bio–psycho–social domains; community-dwelling older adults; frailty; frailty risk factors; nursing; pre-frailty; study protocol.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The SUNFRAIL assessment tool.
Figure 2
Figure 2
Location of the centers participating in SUNFRAIL+ on the map representing the Italian regions (Italy).
Figure 3
Figure 3
SUNFRAIL+ study design and planned intervention.

References

    1. European Commission, Eurostat . Ageing Europe: Looking at the Lives of Older People in the EU: 2020 Edition. Publications Office; Luxembourg, Luxembourg: 2020.
    1. Marois G., Muttarak R., Scherbov S. Assessing the potential impact of COVID-19 on life expectancy. PLoS ONE. 2020;15:e0238678. doi: 10.1371/journal.pone.0238678.
    1. Iaccarino G., Grassi G., Borghi C., Ferri C., Salvetti M., Volpe M. Age and Multimorbidity Predict Death Among COVID-19 Patients: Results of the SARS-RAS Study of the Italian Society of Hypertension. Hypertension. 2020;76:366–372. doi: 10.1161/HYPERTENSIONAHA.120.15324.
    1. Clegg A., Young J., Iliffe S., Rikkert M.O., Rockwood K. Frailty in elderly people. Lancet. 2013;381:752–762. doi: 10.1016/S0140-6736(12)62167-9.
    1. Gobbens R.J., van Assen M.A., Luijkx K.G., Wijnen-Sponselee M.T., Schols J.M. Determinants of frailty. J. Am. Med. Dir. Assoc. 2010;11:356–364. doi: 10.1016/j.jamda.2009.11.008.
    1. Vejux J., le Bruchec S., Bernat V., Beauvais C., Beauvais N., Berrut G. Fragilité et qualité de vie, les apports de l’activité physique chez la personne âgée [Fragility and quality of life, the benefits of physical activity for the elderly] Geriatr. Psychol. Neuropsychiatr. Vieil. 2021;19:127–136. doi: 10.1684/pnv.2021.0924.
    1. Hoogendijk E.O., Afilalo J., Ensrud K.E., Kowal P., Onder G., Fried L.P. Frailty: Implications for clinical practice and public health. Lancet. 2019;394:1365–1375. doi: 10.1016/S0140-6736(19)31786-6.
    1. Heuberger R.A. The frailty syndrome: A comprehensive review. J. Nutr. Gerontol. Geriatr. 2011;30:315–368. doi: 10.1080/21551197.2011.623931.
    1. Obbia P., Graham C., Duffy F.J.R., Gobbens R.J.J. Preventing frailty in older people: An exploration of primary care professionals’ experiences. Int. J. Older People Nurs. 2020;15:e12297. doi: 10.1111/opn.12297.
    1. Uchmanowicz I., Jankowska-Polańska B., Wleklik M., Lisiak M., Gobbens R. Frailty Syndrome: Nursing Interventions. SAGE Open Nurs. 2018;4:2377960818759449. doi: 10.1177/2377960818759449.
    1. Illario M., De Luca V., Tramontano G., Menditto E., Iaccarino G., Bertorello L., Palummeri E., Romano V., Moda G., Maggio M., et al. The Italian reference sites of the European innovation partnership on active and healthy ageing: Progetto Mattone Internazionale as an enabling factor. Ann. Ist. Super. Sanita. 2017;53:60–69.
    1. ProMIS Documento Infermiere di Famiglia e di Comunità. [(accessed on 6 October 2022)]. Available online: .
    1. Decreto 23 Maggio 2022, n. 77. Regolamento Recante la Definizione di Modelli e Standard per lo Sviluppo Dell’assistenza Territoriale nel Servizio Sanitario Nazionale. [(accessed on 6 October 2022)]; Available online: .
    1. Wallington S.L. Frailty: A term with many meanings and a growing priority for community nurses. Br. J. Community Nurs. 2016;21:385–389. doi: 10.12968/bjcn.2016.21.8.385.
    1. SUNFRAIL Project (Reference Sites Network for Prevention and Care of Frailty and Chronic Conditions in Community Dwelling Persons of EU Countries) [(accessed on 6 October 2022)]. Available online:
    1. Maggio M., Barbolini M., Longobucco Y., Barbieri L., Benedetti C., Bono F., Cacciapuoti I., Donatini A., Iezzi E., Papini D., et al. A Novel Tool for the Early Identification of Frailty in Elderly People: The Application in Primary Care Settings. J. Frailty Aging. 2020;9:101–106. doi: 10.14283/jfa.2019.41.
    1. Roller-Wirnsberger R., Liotta G., Lindner S., De Luca V. Public health and clinical approach to proactive management of frailty in multidimensional arena. Ann. Ig. 2021;33:543–554.
    1. De Luca V., Femminella G.D., Patalano R., Formosa V., Lorusso G., Rivetta C., Di Lullo F., Mercurio L., Rea T., Salvatore E., et al. Assessment Tools of Biopsychosocial Frailty Dimensions in Community-Dwelling Older Adults: A Narrative Review. Int. J. Environ. Res. Public Health. 2022;19:16050. doi: 10.3390/ijerph192316050.
    1. SOLE Study Group Translation and initial validation of the Medication Adherence Report Scale (MARS) in Italian patients with Crohn’s Disease. Dig. Liver Dis. 2019;51:640–647. doi: 10.1016/j.dld.2018.09.026.
    1. Martínez-González M.A., García-Arellano A., Toledo E., Salas-Salvado J., Buil-Cosiales P., Corella D., Covas M.I., Schröder H., Aros F., Gomez-Gracia E., et al. A 14-item Mediterranean diet assess- 649 ment tool and obesity indexes among high-risk subjects: The PREDIMED trial. PLoS ONE. 2012;7:e43134. doi: 10.1371/journal.pone.0043134.
    1. Kaiser M.J., Bauer J.M., Ramsch C., Uter W., Guigoz Y., Cederholm T., Thomas D.R., Anthony P., Charlton K.E., Maggio M., et al. Validation of the Mini Nutritional Assessment short-form (MNA-SF): A practical tool for identification of nutritional status. J. Nutr. Health Aging. 2009;13:782–788. doi: 10.1007/s12603-009-0214-7.
    1. Welch S.A., Ward R.E., Beauchamp M.K., Leveille S.G., Travison T., Bean J.F. The Short Physical Performance Battery (SPPB): A Quick and Useful Tool for Fall Risk Stratification Among Older Primary Care Patients. J. Am. Med. Dir. Assoc. 2021;22:1646–1651. doi: 10.1016/j.jamda.2020.09.038.
    1. Garner I.W., Holland C.A. Age-friendliness of living environments from the older person’s viewpoint: Development of the Age-Friendly Environment Assessment Tool. Age Ageing. 2020;49:193–198. doi: 10.1093/ageing/afz146.
    1. Herman T., Giladi N., Hausdorff J.M. Properties of the ‘timed up and go’ test: More than meets the 919 eye. Gerontology. 2011;57:203–210. doi: 10.1159/000314963.
    1. Iavarone A., the Working Group. Mazzi M.C., Russo G., D’Anna F., Peluso S., Mazzeo P., De Luca V., De Michele G., Iaccarino G., et al. The Italian version of the quick mild cognitive impairment (Qmci-I) screen: Normative study on 307 healthy subjects. Aging Clin. Exp. Res. 2019;31:353–360. doi: 10.1007/s40520-018-0981-2.
    1. Brodaty H., Pond D., Kemp N.M., Luscombe G., Harding L., Berman K., Huppert F. The GPCOG: A new screening test for dementia designed for general practice. J. Am. Geriatr. Soc. 2002;50:530–534. doi: 10.1046/j.1532-5415.2002.50122.x.
    1. Gana K., Bailly N., Broc G., Cazauvieilh C., Boudouda N.E. The Geriatric Depression Scale: Does it measure depressive mood, depressive affect, or both? Int. J. Geriatr. Psychiatry. 2017;32:1150–1157. doi: 10.1002/gps.4582.
    1. Caron J. L’Échelle de provisions sociales: La validation québécoise du Social Provisions Scale. St. Ment. Québec. 1996;21:158–180. doi: 10.7202/032403ar.
    1. Tarasenko Y.N., Schoenberg N.E. Self-perceived Income Sufficiency and Self-reported Income Level among a Health Inequity Population. J. Health Care Poor Underserved. 2017;28:812–828. doi: 10.1353/hpu.2017.0076.
    1. Kodraliu G., Mosconi P., Groth N., Carmosino G., Perilli A., Gianicolo E.A., Rossi C., Apolone G. Subjective health status assessment: Evaluation of the Italian version of the SF-12 Health Survey. Results from the MiOS Project. J. Epidemiol. Biostat. 2001;6:305–316. doi: 10.1080/135952201317080715.
    1. Bergquist R., Vereijken B., Mellone S., Corzani M., Helbostad J.L., Taraldsen K. App-based Self-administrable Clinical Tests of Physical Function: Development and Usability Study. JMIR Mhealth Uhealth. 2020;8:e16507. doi: 10.2196/16507.
    1. International Council for Harmonisation (ICH) E6 Good Clinical Practice (GCP) Guideline. [(accessed on 29 November 2022)]. Available online: .
    1. O’Caoimh R., Molloy D.W., Fitzgerald C., Van Velsen L., Cabrita M., Nassabi M.H., de Vette F., van Weering M.D., Jansen-Kosterink S., Kenter W., et al. ICT-supported interventions targeting pre-frailty: Healthcare recommendations from the personalised ICT supported service for independent living and active ageing (PERSSILAA) study. In: Maciaszek L., ODonoghue J., Molloy W., Rocker C., Ziefle M., editors. Information and Communication Technologies for Ageing Well and e-Health: 3rd International Conference, ICT4AWE 2017, Revised Selected Papers. Springer; Berlin/Heidelberg, Germany: 2018. pp. 69–92.
    1. Illario M., De Luca V., Onorato G., Tramontano G., Carriazo A.M., Roller-Wirnsberger R.E., Apostolo J., Eklund P., Goswami N., Iaccarino G., et al. Interactions Between EIP on AHA Reference Sites and Action Groups to Foster Digital Innovation of Health and Care in European Regions. Clin. Interv. Aging. 2022;17:343–358. doi: 10.2147/CIA.S323723.
    1. OECD . Improving Health Sector Efficiency: The Role of Information and Communication Technologies, OECD Health Policy Studies. OECD Publishing; Paris, France: 2010.
    1. Kim K.I., Gollamudi S.S., Steinhubl S. Digital technology to enable aging in place. Exp. Gerontol. 2017;88:25–31. doi: 10.1016/j.exger.2016.11.013.

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