Frailty in elderly people.
Frailty in elderly people.
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DOI：
10.1016/s0140-6736(12)62167-9
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发表时间：
2013-03-02
期刊：
影响因子：
168.9
通讯作者：
Rockwood, Kenneth
中科院分区：
文献类型：
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作者：
Clegg, Andrew;Young, John;Iliffe, Steve;Rikkert, Marcel Olde;Rockwood, Kenneth
虚弱是人口老龄化最成问题的表现。它是一种在应激后容易出现体内平衡不稳定的状态，是一生中多个生理系统累积衰退的结果。这种累积的下降会侵蚀体内平衡储备，直到相对较小的压力事件引发健康状况的不成比例的变化，通常是跌倒或精神错乱。具有里程碑意义的研究已经开发出了有效的衰弱模型，并且这些模型使得流行病学研究能够证明衰弱与不良健康结果之间的关联。需要新的研究来开发更有效的方法来检测和严重程度分级虚弱，作为常规临床实践的一部分，特别是适用于初级保健的方法。这将为适当选择老年人进行侵入性手术或药物治疗提供重要信息，并将成为体弱老年人护理模式向更适当的目标导向护理转变的基础。
Frailty is the most problematic expression of population ageing. It is a state of vulnerability to poor resolution of homeostasis following a stress and is a consequence of cumulative decline in multiple physiological systems over a lifespan. This cumulative decline erodes homeostatic reserve until relatively minor stressor events trigger disproportionate changes in health status, typically a fall or delirium. Landmark studies have developed valid models for frailty and these have allowed epidemiological studies that demonstrate the association of frailty with adverse health outcomes. New research is needed to develop more efficient methods to detect and severity grade frailty as part of routine clinical practice, particularly methods with utility for primary care. This would greatly inform the appropriate selection of older people for invasive procedures or medications and would be the basis for a paradigm shift in the care of frail older people towards a more appropriate goal-directed care.