Abstract
Objective: The task force of the International Conference of Frailty and Sarcopenia Research (ICFSR) developed these clinical practice guidelines to overview the current evidence-base and to provide recommendations for the identification and management of frailty in older adults. Methods: These recommendations were formed using the GRADE approach, which ranked the strength and certainty (quality) of the supporting evidence behind each recommendation. Where the evidence-base was limited or of low quality, Consensus Based Recommendations (CBRs) were formulated. The recommendations focus on the clinical and practical aspects of care for older people with frailty, and promote person-centred care. Recommendations for Screening and Assessment: The task force recommends that health practitioners case identify/screen all older adults for frailty using a validated instrument suitable for the specific setting or context (strong recommendation). Ideally, the screening instrument should exclude disability as part of the screening process. For individuals screened as positive for frailty, a more comprehensive clinical assessment should be performed to identify signs and underlying mechanisms of frailty (strong recommendation). Recommendations for Management: A comprehensive care plan for frailty should address polypharmacy (whether rational or nonrational), the management of sarcopenia, the treatable causes of weight loss, and the causes of exhaustion (depression, anaemia, hypotension, hypothyroidism, and B12 deficiency) (strong recommendation). All persons with frailty should receive social support as needed to address unmet needs and encourage adherence to a comprehensive care plan (strong recommendation). First-line therapy for the management of frailty should include a multi-component physical activity programme with a resistance-based training component (strong recommendation). Protein/caloric supplementation is recommended when weight loss or undernutrition are present (conditional recommendation). No recommendation was given for systematic additional therapies such as cognitive therapy, problem-solving therapy, vitamin D supplementation, and hormone-based treatment. Pharmacological treatment as presently available is not recommended therapy for the treatment of frailty.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 771-787 |
| Number of pages | 17 |
| Journal | Journal of Nutrition, Health and Aging |
| Volume | 23 |
| Issue number | 9 |
| DOIs | |
| State | Published - Nov 1 2019 |
| Externally published | Yes |
Fingerprint
Keywords
- 80 and over
- Aged
- Frailty/diagnosis
- Frailty/therapy*
- Patient Care Planning/standards
- Practice guideline
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Nutrition and Dietetics
- Geriatrics and Gerontology
Cite this
Physical Frailty : ICFSR International Clinical Practice Guidelines for Identification and Management. / Dent, E.; Morley, J. E.; Cruz-Jentoft, A. J.; Woodhouse, L.; Rodríguez-Mañas, L.; Fried, L. P.; Woo, J.; Aprahamian, I.; Sanford, A.; Lundy, J.; Landi, F.; Beilby, J.; Martin, F. C.; Bauer, J. M.; Ferrucci, L.; Merchant, R. A.; Dong, B.; Arai, H.; Hoogendijk, E. O.; Won, C. W.; Abbatecola, A.; Cederholm, T.; Strandberg, T.; Gutiérrez Robledo, L. M.; Flicker, L.; Bhasin, S.; Aubertin-Leheudre, M.; Bischoff-Ferrari, H. A.; Guralnik, J. M.; Muscedere, J.; Pahor, M.; Ruiz, J.; Negm, A. M.; Reginster, J. Y.; Waters, D. L.; Vellas, B.
In: Journal of Nutrition, Health and Aging, Vol. 23, No. 9, 01.11.2019, p. 771-787.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Physical Frailty
T2 - ICFSR International Clinical Practice Guidelines for Identification and Management
AU - Dent, E.
AU - Morley, J. E.
AU - Cruz-Jentoft, A. J.
AU - Woodhouse, L.
AU - Rodríguez-Mañas, L.
AU - Fried, L. P.
AU - Woo, J.
AU - Aprahamian, I.
AU - Sanford, A.
AU - Lundy, J.
AU - Landi, F.
AU - Beilby, J.
AU - Martin, F. C.
AU - Bauer, J. M.
AU - Ferrucci, L.
AU - Merchant, R. A.
AU - Dong, B.
AU - Arai, H.
AU - Hoogendijk, E. O.
AU - Won, C. W.
AU - Abbatecola, A.
AU - Cederholm, T.
AU - Strandberg, T.
AU - Gutiérrez Robledo, L. M.
AU - Flicker, L.
AU - Bhasin, S.
AU - Aubertin-Leheudre, M.
AU - Bischoff-Ferrari, H. A.
AU - Guralnik, J. M.
AU - Muscedere, J.
AU - Pahor, M.
AU - Ruiz, J.
AU - Negm, A. M.
AU - Reginster, J. Y.
AU - Waters, D. L.
AU - Vellas, B.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Objective: The task force of the International Conference of Frailty and Sarcopenia Research (ICFSR) developed these clinical practice guidelines to overview the current evidence-base and to provide recommendations for the identification and management of frailty in older adults. Methods: These recommendations were formed using the GRADE approach, which ranked the strength and certainty (quality) of the supporting evidence behind each recommendation. Where the evidence-base was limited or of low quality, Consensus Based Recommendations (CBRs) were formulated. The recommendations focus on the clinical and practical aspects of care for older people with frailty, and promote person-centred care. Recommendations for Screening and Assessment: The task force recommends that health practitioners case identify/screen all older adults for frailty using a validated instrument suitable for the specific setting or context (strong recommendation). Ideally, the screening instrument should exclude disability as part of the screening process. For individuals screened as positive for frailty, a more comprehensive clinical assessment should be performed to identify signs and underlying mechanisms of frailty (strong recommendation). Recommendations for Management: A comprehensive care plan for frailty should address polypharmacy (whether rational or nonrational), the management of sarcopenia, the treatable causes of weight loss, and the causes of exhaustion (depression, anaemia, hypotension, hypothyroidism, and B12 deficiency) (strong recommendation). All persons with frailty should receive social support as needed to address unmet needs and encourage adherence to a comprehensive care plan (strong recommendation). First-line therapy for the management of frailty should include a multi-component physical activity programme with a resistance-based training component (strong recommendation). Protein/caloric supplementation is recommended when weight loss or undernutrition are present (conditional recommendation). No recommendation was given for systematic additional therapies such as cognitive therapy, problem-solving therapy, vitamin D supplementation, and hormone-based treatment. Pharmacological treatment as presently available is not recommended therapy for the treatment of frailty.
AB - Objective: The task force of the International Conference of Frailty and Sarcopenia Research (ICFSR) developed these clinical practice guidelines to overview the current evidence-base and to provide recommendations for the identification and management of frailty in older adults. Methods: These recommendations were formed using the GRADE approach, which ranked the strength and certainty (quality) of the supporting evidence behind each recommendation. Where the evidence-base was limited or of low quality, Consensus Based Recommendations (CBRs) were formulated. The recommendations focus on the clinical and practical aspects of care for older people with frailty, and promote person-centred care. Recommendations for Screening and Assessment: The task force recommends that health practitioners case identify/screen all older adults for frailty using a validated instrument suitable for the specific setting or context (strong recommendation). Ideally, the screening instrument should exclude disability as part of the screening process. For individuals screened as positive for frailty, a more comprehensive clinical assessment should be performed to identify signs and underlying mechanisms of frailty (strong recommendation). Recommendations for Management: A comprehensive care plan for frailty should address polypharmacy (whether rational or nonrational), the management of sarcopenia, the treatable causes of weight loss, and the causes of exhaustion (depression, anaemia, hypotension, hypothyroidism, and B12 deficiency) (strong recommendation). All persons with frailty should receive social support as needed to address unmet needs and encourage adherence to a comprehensive care plan (strong recommendation). First-line therapy for the management of frailty should include a multi-component physical activity programme with a resistance-based training component (strong recommendation). Protein/caloric supplementation is recommended when weight loss or undernutrition are present (conditional recommendation). No recommendation was given for systematic additional therapies such as cognitive therapy, problem-solving therapy, vitamin D supplementation, and hormone-based treatment. Pharmacological treatment as presently available is not recommended therapy for the treatment of frailty.
KW - 80 and over
KW - Aged
KW - Frailty/diagnosis
KW - Frailty/therapy
KW - Patient Care Planning/standards
KW - Practice guideline
UR - http://www.scopus.com/inward/record.url?scp=85073614371&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85073614371&partnerID=8YFLogxK
U2 - 10.1007/s12603-019-1273-z
DO - 10.1007/s12603-019-1273-z
M3 - Article
C2 - 31641726
AN - SCOPUS:85073614371
VL - 23
SP - 771
EP - 787
JO - Journal of Nutrition, Health and Aging
JF - Journal of Nutrition, Health and Aging
SN - 1279-7707
IS - 9
ER -