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Management of frailty at individual level – clinical management: Systematic literature review

Gregor Veninšek

Gregor Veninšek

University Medical Center Ljubljana, Center for Geriatric MedicineLjubljana, Slovenia
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Veninšek, Gregor
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Branko Gabrovec

Branko Gabrovec

National Institute of Public Health, Health Care CenterLjubljana, Slovenia
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Gabrovec, Branko
  
12 avr. 2018
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Catégorie d'article: Review article
Publié en ligne: 12 avr. 2018
Pages: 106 - 115
Reçu: 14 août 2017
Accepté: 23 janv. 2018
DOI: https://doi.org/10.2478/sjph-2018-0014
Mots clés
© 2018 National Institute of Public Health, Slovenia
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Flowchart of search strategy and literature selection process
Flowchart of search strategy and literature selection process

Results of the quality assessment of systematic literature review_

 CriteriaYesNoOther
1.   Is the review based on a focused question that is adequately formulated and described?X
2.   Were eligibility criteria for included and excluded studies predefined and specified?X
3.   Did the literature search strategy use a comprehensive, systematic approach?X
4.   Were titles, abstracts, and full-text articles dually and independently reviewed for inclusion and exclusion to minimize bias?X
5.   Was the quality of each included study rated independently by two or more reviewers, using a standard method to appraise its internal validity?X
6.   Were the included studies listed along with important characteristics and results of each study?X
7.   Was publication bias assessed?X
8.   Was heterogeneity assessed? (This question applies only to meta-analyses.)X

Results of the review and literature analysis_

 Author and yearResearch designSampleResearch purposeKey findings
Kehler et al., 2017Cross-sectional. Surveyn=7353To examine and compare the prevalence of frailty in Canadians 18–79 years old using the Accumulation of Deficits and Fried models of frailty.Data show that frailty is prevalent already in younger adults, has increasing prevalence with age, which varies depending on which frailty tool is used.
Gobbens et al., 2010Cross-sectional75 years old and older n=484To determine which determinants predict frailty and domains of frailty.The effect of the determinants of frailty differs across frailty domains.
Gill et al., 2006Prospective study70 years and older n=754To determine the transition rates between frailty states.Frailty is a dynamic process, characterised by frequent transitions between frailty states over time.
Fried et al., 2001Prospective and observational study65 years and older n=5317To develop and operationalize a phenotype of frailty in older adults.The study provides a potentially standardised definition for frailty.
Clegg et al., 2013Literature review an observational study80 years old and olderA research on how frailty develops, how it might be prevented and how it can be detected reliably.Landmark studies have developed valid models for frailty.
Kan et al., 2008Literature review, Expert panelGeriatric Advisory PanelTo perform a comprehensive review of the definitions and assessment tools on frailty.No consensus on the definition of frailty, but there was an agreement to consider frailty as a pre-disability stage.
Dent et al., 2016Literature rev’ew65 years old and older n=29An overview of the definitions and measurements of frailty in research and clinical practice.A summary of the main strengths and limitations of existing frailty measurements.
Stoicea et al., 2016Literature reviewReviews of six scales.Review scales for measuring frailty.By identifying the most time-efficient criteria, a comprehensive and clinically effective scale, a universal scale can be implemented.
Subra et al., 2012Literature and platform rev’ew, observational study65 years old and older n=160The presentation of the main characteristics of the new Platform.The Platform clinically evaluates and intervenes on frailty for the first time at the general population level.
Vellas et al., 2013Screening tool review and observational study65 years old and older n=442A screening tool for frailtyThe use of the GFST may help at raising awareness about the importance of identifying frailty.
Morley et al., 2013Consensus groupDelegates from 6 major international, European, and US societies.To create 4 major consensus points on the specific form of frailty.Physical frailty can potentially be prevented or treated.
Sutton et al., 2016Literature review73 articles selected 60 years old and olderTo identify existing multicomponent frailty assessment tools that were developed to assess frailty.The TFI has the most robust evidence of reliability and validity.
Ellis et al., 2011Rev’ew of randomised controlled trialsTwo reviewsTo evaluate the effectiveness of CGA in the hospital.CGA increases a patient’s likelihood of being alive and in their own home.
Theou et al., 2011Literature review47 studies selectedTo examine the effectiveness of current exercise interventions for the management of frailty.Evidence suggests that exercise has a positive impact on some physical determinants of frailty.
Beaudart et al., 2014Literature review, Meta-analyse30 studies selectedTo summarise with a metaanalysis the effects of vitamin D supplementation.Vitamin D supplementation has a small positive impact on muscle strength.
Bruyčre et al., 2017Literature reviewNo dataA rev’ew of the ev’dence regarding the role of v’tamin D.Several studies suggest a potential effect of v’tamin D on physical frailty.
Cesari et al., 2015Exploratory analysesMean age=76.8 years n=424To explore whether a physical activity intervention can reduce prevalence and severity of frailty.Regular PA may reduce frailty, especially in individuals at higher risk of disability.
Ng et al., 2015Randomised controlled trialMean age=70 years n=151To compare the effects of 6-month-duration interventions vs. control in reducing frailty.Physical, nutritional, and cognitive interventional approaches were effective in reversing frailty.
Song et al., 2010Prospective cohort studyAged from 65 to 102 years n=2740To evaluate the prevalence and 10-year outcomes of frailty in older adults.The prevalence of frailty increases with age and, at any age, lessens survival.
Puts et al., 2017Literature review65 years old and older 14 studies selectedTo review policies that are designed to prevent or reduce the level of frailty.The best interventions and policies to prevent or reduce the level of frailty.
Turner et al., 2014Literature review, ReportNo dataTo create proactive, integrated, person-centred and community-based response to frailty.The British Geriatrics Society Fit for Frailty guideline is by consensus the best practice guidance for managing frailty.
Collard et al., 2012Literature review65 years old and older 21 studies selectedTo systematically compare and pool the prevalence of frailty, including pre-frailty.Different operationalization of frailty status results in widely differing prevalence between studies.
Gill et al., 2004Randomised controlled trial75 years old and older n=188To determine whether a home-based physical therapy program prevents a decline in several higher-level measures of physical function.Home-based pre-habilitation program offered modest, but consistent benefits.
Chan et al., 2012Randomised controlled trial65-79 years old n=117To report interventions targeting the improvement of frailty status as an outcome.The three-month intervention resulted in short-term frailty status improvement.
Li et al., 2010Randomised controlled trial65 years old and older n=310To assess the effectiveness of CGA.CGA showed a favourable outcome in frail and pre-frail older people.
Cameron et al., 2013Randomized controlled trialMean age=83,3 years n=216To determine whether an intervention could reduce frailty and improve mobility.Frailty and mobility disability can be successfully treated.
Behm et al., 2016Randomised controlled trial80 years old and older n=459To determine whether preventive home visits could postpone deterioration in frailty.The results of this study show the potential of health promotion to older persons.

Search table_

Key wordNo. of hitsChosen hitsRepeated chosen hitsRepeated chosen hits
PubMedComprehensive Geriatric Assessment3054112124
Frail Disability1332441
Frailty treatment3689883
Frail Older adult11223642
Frailty Screening3932
Frailty management1491772
Frailty Intervention Therapy409992
Functional Decline141231122
CochraneComprehensive Geriatric Assessment287222
Frail Older person44211
Geriatric Vulnerable70111
Elderly Vulnerable175111
EmbaseComprehensive Geriatric Assessment880200
Frailty Scale148200
Functional decline1100016162
CINAHLComprehensive Geriatric Assessment410551
Frailty Scale53000
UpToDateFrail Older adult795200
Frailty Intervention Therapy3051300
Frail Older person390600
Other sources11
6743211827
Langue:
Anglais
Périodicité:
4 fois par an
Sujets de la revue:
Médecine, Médecine clinique, Hygiène et médecine environnementale
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