Cameron Ian D, Kurrle Susan E
John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, The University of Sydney, Kolling Institute, Royal North Shore Hospital, St Leonards, N.S.W., Australia.
Interdiscip Top Gerontol Geriatr. 2015;41:137-50. doi: 10.1159/000381229. Epub 2015 Jul 17.
Rehabilitation approaches to frailty are in the early stages of development. Frailty also shows promise as a prognostic indicator for rehabilitation programs, similar to its application in other areas of medicine. However, care should be taken not to exclude frail older people from rehabilitation, as has been the case at some centers for people with cognitive impairment or very severe disability. There are clear theoretical reasons to expect that a rehabilitation approach will be effective. Some experimental data are also available suggesting that rehabilitation is effective in frail and pre-frail older people. The principles of a frailty intervention program that have been demonstrated to be clinically and economically effective are as follows: first, frailty can be mitigated; second, support needs are individually addressed; third, the interventions aim to improve physical, cognitive and social functioning; fourth, support has to be delivered over a long time period; and finally, systems must facilitate consistent management. Most frail older people are encouraged and supported to adhere to their intervention plan. It is important to recognize the needs of families and/or carers and to engage with them.
针对衰弱的康复方法尚处于发展初期。衰弱作为康复项目的预后指标也显示出前景,这与它在医学其他领域的应用类似。然而,应注意避免像一些针对认知障碍或极重度残疾患者的中心那样,将衰弱的老年人排除在康复之外。有明确的理论依据预期康复方法会有效。也有一些实验数据表明康复对衰弱和衰弱前期的老年人有效。已被证明在临床和经济上有效的衰弱干预项目原则如下:第一,衰弱可以减轻;第二,支持需求需个别处理;第三,干预旨在改善身体、认知和社会功能;第四,支持必须长期提供;最后,系统必须便于进行持续管理。大多数衰弱的老年人会受到鼓励并得到支持以坚持他们的干预计划。认识到家庭和/或照料者的需求并与他们合作很重要。