"Focusing on positive outcomes in frailty research": a step in a right direction.
"Focusing on positive outcomes in frailty research": a step in a right direction.
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“关注衰弱研究的积极成果”：朝着正确方向迈出的一步。
DOI：
10.1017/s1041610219000607
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发表时间：
2019
影响因子：
7
通讯作者：
Rubtsova,AnnaA
中科院分区：
文献类型：
--
作者：
Rubtsova,AnnaA
老年人的脆弱性日益受到关注。尽管没有标准化的定义，但越来越多的人认为虚弱是一种老年综合征，其特征是生理储备减少和对内部和外部压力源的脆弱性增加（莫利等人，2013; Rodriguez Manas等人，2018年）。据估计，大约10%的65岁及以上的社区居住成年人可以被归类为身体虚弱（Collard等人，2012年）。在人口老龄化的背景下，这一统计数字可能令人震惊。到2060年，欧洲65岁及以上成年人的比例预计将达到28%，美国将达到24%（9，470万）（Rodriguez Manas等人，2018年;美国人口普查局，2018年）。考虑到这些预测和目前的虚弱患病率，这意味着到2060年，仅在美国就有950万老年人可能达到虚弱标准。虚弱人群面临不良临床结果的风险增加，如福尔斯、住院、机构化、残疾和死亡（Clegg et al.，2013年）。然而，虚弱不是静态的;它可以被逆转或减少，特别是在其早期阶段（Puts等人，2017年）。毫不奇怪，虚弱越来越多地被视为公共卫生优先事项（Cesari等人，2016），并且已经制定了各种旨在预防或逆转其的国际政策（Puts et al.，2017年）。虚弱国际共识小组发表了一份声明，呼吁医疗保健提供者对所有70岁及以上的人以及因慢性疾病而体重显著减轻（≥ 5%）的人进行常规虚弱筛查（莫利等人，2013年）。然而，脆弱性研究及其转化为临床实践已经成熟的困难。首先，虚弱一直难以定义，这可能是由于其复杂的病因以及难以将其与衰老和残疾区分开（Dent等人，2016年）。多年来，虚弱的多种定义与不同的操作化相关联，并且仍然存在关于测量它的最佳方法的争论（Dent等人，2016; Huisingh-Scheetz等人，2019年）。对脆弱性的研究也因其主要关注风险因素和不良后果而受到阻碍。鉴于有大量的生物医学研究（如合并症），
Frailty among older adults is of increasing concern. Even though no standardized definition exists, there is a growing consensus that frailty is a geriatric syndrome characterized by diminished physiologic reserve and increased vulnerability to internal and external stressors (Morley et al., 2013; Rodriguez Manas et al., 2018). It has been estimated that about 10% of community-dwelling adults aged 65 years and older can be classified as physically frail (Collard et al., 2012). This statistic can be alarming in the context of an aging population. The proportion of adults aged 65 years and older is projected to reach 28% in Europe and 24%(94.7 million) in the United States (US) by the year 2060 (Rodriguez Manas et al., 2018; United States Census Bureau, 2018). Given these projections and the current frailty prevalence, it means that by the year 2060 a staggering 9.5 million older adults may meet frailty criteria in the US alone.People with frailty face an increased risk of adverse clinical outcomes, such as falls, hospitalizations, institutionalization, disability, and mortality (Clegg et al., 2013). Frailty, however, is not static; it can be reversed or reduced, especially at its early stages (Puts et al., 2017). Not surprisingly, frailty is increasingly viewed as a public health priority (Cesari et al., 2016) and various international policies have been developed aiming at its prevention or reversal (Puts et al., 2017). The international consensus group on frailty has issued a statement, calling for routine frailty screening by healthcare providers of all persons 70 years and older as well as those with significant weight loss (≥ 5%) due to chronic disease (Morley et al., 2013). Yet, both frailty research and its translation into clinical practice have been ripe with difficulties. Firstly, frailty has been hard to define, perhaps due to its complex etiology as well as difficulty distinguishing it from aging and disability (Dent et al., 2016). Over the years, multiple definitions of frailty became associated with diverse operationalizations, and there are still debates about the best ways to measure it (Dent et al., 2016; Huisingh-Scheetz et al., 2019). The research on frailty has also been deterred by its primary focus on risk factors and adverse outcomes. Whereas there is a good deal of research on biomedical (eg, comorbidities),