Roessingh Research and Development, Roessinghsbleekweg 33b, 7522, AL, Enschede, The Netherlands.
University of Twente, Faculty of Electrical Engineering, Mathematics and Computer Science, Telemedicine group, Enschede, the Netherlands.
BMC Public Health. 2019 May 3;19(1):504. doi: 10.1186/s12889-019-6876-0.
Among community-dwelling older adults, frailty is highly prevalent and recognized as a major public health concern. To prevent frailty it is important to identify those at risk of becoming frail, but at present, no accepted screening procedure is available.
The screening process developed as part of the PERSSILAA project is a two-step screening pathway. First, older adults are asked to complete a self-screening questionnaire to assess their general health status and their level of decline on physical, cognitive and nutritional domains. Second, older adults who, according to step one, are at risk of becoming frail, are invited for a face-to-face assessment focusing on the domains in depth. We deployed the PERSSILAA screening procedure in primary care in the Netherlands.
In total, baseline data were available for 3777 community-dwelling older adults (mean age 69.9 (SD ± 3.8)) who completed first step screening. Based on predefined cut-off scores, 16.8% of the sample were classified as frail (n = 634), 20.6% as pre-frail (n = 777), and 62.3% as robust (n = 2353). Frail subjects were referred back to their GP without going through the second step. Of the pre-frail older adults, 69.7% had evidence of functional decline on the physical domain, 67% were overweight or obese and 31.0% had evidence of cognitive decline.
Pre-frailty is common among community-dwelling older adults. The PERSSILAA screening approach is a multi-factor, two-step screening process, potentially useful for primary prevention to identify those at risk of frailty and who will benefit most from preventive strategies.
在社区居住的老年人中，衰弱症的发病率很高，被认为是一个主要的公共卫生问题。为了预防衰弱症，识别那些有衰弱风险的人是很重要的，但目前还没有公认的筛查程序。
作为 PERSSILAA 项目的一部分开发的筛选过程是一个两步筛选途径。首先，要求老年人完成自我筛选问卷，以评估他们的一般健康状况以及身体、认知和营养领域的衰退程度。其次，根据第一步，那些有衰弱风险的老年人将被邀请进行面对面的评估，重点关注这些领域。我们在荷兰的初级保健中部署了 PERSSILAA 筛选程序。
共有 3777 名居住在社区的老年人（平均年龄 69.9（±3.8））完成了第一步的筛选，他们提供了基线数据。根据预先设定的截断分数，16.8%的样本被归类为衰弱（n=634），20.6%为衰弱前期（n=777），62.3%为强健（n=2353）。衰弱的患者被直接转回他们的家庭医生，而不需要进行第二步评估。在衰弱前期的老年人中，69.7%在身体领域有功能下降的证据，67%超重或肥胖，31.0%有认知能力下降的证据。
衰弱前期在社区居住的老年人中很常见。PERSSILAA 筛选方法是一种多因素、两步筛选过程，可能对初级预防有用，以识别那些有衰弱风险的人，并使他们从预防策略中获益最多。
