Promoting access to innovation for frail old persons
Promoting access to innovation for frail old persons
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DOI：
10.1007/s12603-013-0039-2
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发表时间：
2013-08-01
影响因子：
5.8
通讯作者：
Benetos, A.
中科院分区：
文献类型：
--
作者：
Berrut, G.;Andrieu, S.;Benetos, A.
衰弱往往被认为是老年人不良后果的主要风险，但一些重要方面仍然存在争议。本文的目的是提出专家对老年人衰弱综合征主要方面的立场。研讨会由国际老年学和老年病学协会 (IAGG)、世界卫生组织 (WHO) 和 Soci,t, Fran double dagger aise de G,riatrie et de G,rontologie (SFGG) 组织。被广泛认为是老年人不良健康结果的一个重要危险因素。这对于评估患有慢性病的非残疾老年人可能具有特别的价值，但目前尚未制定可操作的定义。营养状况、活动能力、活动、力量、耐力、认知和情绪被认为是虚弱的标志。另一种方法计算从“非常健康”到“严重虚弱”的多维评分，但很难应用于医疗实践。虚弱似乎是继发于多种情况，使用多种途径导致对压力源的脆弱性。生物因素（炎症、激素缺失）、临床因素（肌肉减少症、骨质疏松症等）以及社会因素（隔离、财务状况）都参与了脆弱性过程。在临床实践中，由于老年人癌症患病率高且药物治疗的耐受性差，衰弱检测引起了肿瘤学的重大兴趣。在老年人群心血管风险的定义中还应考虑到虚弱的存在。研讨会专家列出了达成共识的要点，以及在实践中提高对衰弱综合症的理解和使用必须优先考虑的要点。老年人衰弱是一种与应激源脆弱性相对应的综合症。诊断工具已经开发出来，但没有一个能够同时整合大量因素和临床实践所要求的简单性。有必要与国际通用定义达成一致，以开展筛查并减少老年人的发病率。
Frailty tends to be considered as a major risk for adverse outcomes in older persons, but some important aspects remain matter of debate.The purpose of this paper is to present expert's positions on the main aspects of the frailty syndrome in the older persons.Workshop organized by International Association of Gerontology and Geriatrics (IAGG), World Health Organization (WHO) and Soci,t, Fran double dagger aise de G,riatrie et de G,rontologie (SFGG).Frailty is widely recognized as an important risk factor for adverse health outcomes in older persons. This can be of particular value in evaluating non-disabled older persons with chronic diseases but today no operational definition has been established. Nutritional status, mobility, activity, strength, endurance, cognition, and mood have been proposed as markers of frailty. Another approach calculates a multidimensional score ranging from "very fit" to "severely frail," but it is difficult to apply into the medical practice. Frailty appears to be secondary to multiple conditions using multiple pathways leading to a vulnerability to a stressor. Biological (inflammation, loss of hormones), clinical (sarcopenia, osteoporosis etc.), as well as social factors (isolation, financial situation) are involved in the vulnerability process. In clinical practice, detection of frailty is of major interest in oncology because of the high prevalence of cancer in older persons and the bad tolerance of the drug therapies. Presence of frailty should also be taken into account in the definition of the cardiovascular risks in the older population. The experts of the workshop have listed the points reached an agreement and those must to be a priority for improving understanding and use of frailty syndrome in practice.Frailty in older adults is a syndrome corresponding to a vulnerability to a stressor. Diagnostic tools have been developed but none can integrate at the same time the large spectrum of factors and the simplicity asked by the clinical practice. An agreement with an international common definition is necessary to develop screening and to reduce the morbidity in older persons.