Frailty: implications for clinical practice and public health

Emiel O. Hoogendijk, Jonathan Afilalo, Kristine E. Ensrud, Paul Kowal, Graziano Onder, Linda P. Fried

Research output: Contribution to journalReview article

Abstract

Frailty is an emerging global health burden, with major implications for clinical practice and public health. The prevalence of frailty is expected to rise alongside rapid growth in the ageing population. The course of frailty is characterised by a decline in functioning across multiple physiological systems, accompanied by an increased vulnerability to stressors. Having frailty places a person at increased risk of adverse outcomes, including falls, hospitalisation, and mortality. Studies have shown a clear pattern of increased health-care costs and use associated with frailty. All older adults are at risk of developing frailty, although risk levels are substantially higher among those with comorbidities, low socioeconomic position, poor diet, and sedentary lifestyles. Lifestyle and clinical risk factors are potentially modifiable by specific interventions and preventive actions. The concept of frailty is increasingly being used in primary, acute, and specialist care. However, despite efforts over the past three decades, agreement on a standard instrument to identify frailty has not yet been achieved. In this Series paper, we provide an overview of the global impact and burden of frailty, the usefulness of the frailty concept in clinical practice, potential targets for frailty prevention, and directions that need to be explored in the future.

Original languageEnglish (US)
Pages (from-to)1365-1375
Number of pages11
JournalThe Lancet
Volume394
Issue number10206
DOIs
StatePublished - Oct 12 2019
Externally publishedYes

Fingerprint

Public Health Practice
Sedentary Lifestyle
Health Care Costs
Life Style
Comorbidity
Hospitalization
Diet
Mortality
Growth
Population

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Hoogendijk, E. O., Afilalo, J., Ensrud, K. E., Kowal, P., Onder, G., & Fried, L. P. (2019). Frailty: implications for clinical practice and public health. The Lancet, 394(10206), 1365-1375. https://doi.org/10.1016/S0140-6736(19)31786-6

Frailty : implications for clinical practice and public health. / Hoogendijk, Emiel O.; Afilalo, Jonathan; Ensrud, Kristine E.; Kowal, Paul; Onder, Graziano; Fried, Linda P.

In: The Lancet, Vol. 394, No. 10206, 12.10.2019, p. 1365-1375.

Research output: Contribution to journalReview article

Hoogendijk, EO, Afilalo, J, Ensrud, KE, Kowal, P, Onder, G & Fried, LP 2019, 'Frailty: implications for clinical practice and public health', The Lancet, vol. 394, no. 10206, pp. 1365-1375. https://doi.org/10.1016/S0140-6736(19)31786-6
Hoogendijk EO, Afilalo J, Ensrud KE, Kowal P, Onder G, Fried LP. Frailty: implications for clinical practice and public health. The Lancet. 2019 Oct 12;394(10206):1365-1375. https://doi.org/10.1016/S0140-6736(19)31786-6
Hoogendijk, Emiel O. ; Afilalo, Jonathan ; Ensrud, Kristine E. ; Kowal, Paul ; Onder, Graziano ; Fried, Linda P. / Frailty : implications for clinical practice and public health. In: The Lancet. 2019 ; Vol. 394, No. 10206. pp. 1365-1375.
@article{88eb05e33acc41fcaf8fc3723a06898c,
title = "Frailty: implications for clinical practice and public health",
abstract = "Frailty is an emerging global health burden, with major implications for clinical practice and public health. The prevalence of frailty is expected to rise alongside rapid growth in the ageing population. The course of frailty is characterised by a decline in functioning across multiple physiological systems, accompanied by an increased vulnerability to stressors. Having frailty places a person at increased risk of adverse outcomes, including falls, hospitalisation, and mortality. Studies have shown a clear pattern of increased health-care costs and use associated with frailty. All older adults are at risk of developing frailty, although risk levels are substantially higher among those with comorbidities, low socioeconomic position, poor diet, and sedentary lifestyles. Lifestyle and clinical risk factors are potentially modifiable by specific interventions and preventive actions. The concept of frailty is increasingly being used in primary, acute, and specialist care. However, despite efforts over the past three decades, agreement on a standard instrument to identify frailty has not yet been achieved. In this Series paper, we provide an overview of the global impact and burden of frailty, the usefulness of the frailty concept in clinical practice, potential targets for frailty prevention, and directions that need to be explored in the future.",
author = "Hoogendijk, {Emiel O.} and Jonathan Afilalo and Ensrud, {Kristine E.} and Paul Kowal and Graziano Onder and Fried, {Linda P.}",
year = "2019",
month = "10",
day = "12",
doi = "10.1016/S0140-6736(19)31786-6",
language = "English (US)",
volume = "394",
pages = "1365--1375",
journal = "The Lancet",
issn = "0140-6736",
publisher = "Elsevier Limited",
number = "10206",

}

TY - JOUR

T1 - Frailty

T2 - implications for clinical practice and public health

AU - Hoogendijk, Emiel O.

AU - Afilalo, Jonathan

AU - Ensrud, Kristine E.

AU - Kowal, Paul

AU - Onder, Graziano

AU - Fried, Linda P.

PY - 2019/10/12

Y1 - 2019/10/12

N2 - Frailty is an emerging global health burden, with major implications for clinical practice and public health. The prevalence of frailty is expected to rise alongside rapid growth in the ageing population. The course of frailty is characterised by a decline in functioning across multiple physiological systems, accompanied by an increased vulnerability to stressors. Having frailty places a person at increased risk of adverse outcomes, including falls, hospitalisation, and mortality. Studies have shown a clear pattern of increased health-care costs and use associated with frailty. All older adults are at risk of developing frailty, although risk levels are substantially higher among those with comorbidities, low socioeconomic position, poor diet, and sedentary lifestyles. Lifestyle and clinical risk factors are potentially modifiable by specific interventions and preventive actions. The concept of frailty is increasingly being used in primary, acute, and specialist care. However, despite efforts over the past three decades, agreement on a standard instrument to identify frailty has not yet been achieved. In this Series paper, we provide an overview of the global impact and burden of frailty, the usefulness of the frailty concept in clinical practice, potential targets for frailty prevention, and directions that need to be explored in the future.

AB - Frailty is an emerging global health burden, with major implications for clinical practice and public health. The prevalence of frailty is expected to rise alongside rapid growth in the ageing population. The course of frailty is characterised by a decline in functioning across multiple physiological systems, accompanied by an increased vulnerability to stressors. Having frailty places a person at increased risk of adverse outcomes, including falls, hospitalisation, and mortality. Studies have shown a clear pattern of increased health-care costs and use associated with frailty. All older adults are at risk of developing frailty, although risk levels are substantially higher among those with comorbidities, low socioeconomic position, poor diet, and sedentary lifestyles. Lifestyle and clinical risk factors are potentially modifiable by specific interventions and preventive actions. The concept of frailty is increasingly being used in primary, acute, and specialist care. However, despite efforts over the past three decades, agreement on a standard instrument to identify frailty has not yet been achieved. In this Series paper, we provide an overview of the global impact and burden of frailty, the usefulness of the frailty concept in clinical practice, potential targets for frailty prevention, and directions that need to be explored in the future.

UR - http://www.scopus.com/inward/record.url?scp=85073036613&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85073036613&partnerID=8YFLogxK

U2 - 10.1016/S0140-6736(19)31786-6

DO - 10.1016/S0140-6736(19)31786-6

M3 - Review article

C2 - 31609228

AN - SCOPUS:85073036613

VL - 394

SP - 1365

EP - 1375

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 10206

ER -