Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
School of Nursing and Midwifery, College of Medicine Nursing & Health Sciences, National University of Ireland Galway, Galway, Ireland.
Front Public Health. 2020 Nov 12;8:599170. doi: 10.3389/fpubh.2020.599170. eCollection 2020.
Across the world, life expectancy is increasing. However, the years of life gained do not always correspond to healthy life years, potentially leading to an increase in frailty. Given the extent of population aging, the association between frailty and age and the impact of frailty on adverse outcomes for older people, frailty is increasingly being recognized to be a significant public health concern. Early identification of the condition is important to help older adults regain function and to prevent the negative outcomes associated with the syndrome. Despite the importance of diagnosing frailty, there is no definitive evidence or consensus of whether screening should be routinely implemented. A broad range of screening and assessment instruments have been developed taking a biopsychosocial approach, characterizing frailty as a dynamic state resulting from deficits in any of the physical, psychological and social domains, which contribute to health. All these aspects of frailty should be identified and addressed using an integrated and holistic approach to care. To achieve this goal, public health and primary health care (PHC) need to become the fulcrum through which care is offered, not only to older people and those that are frail, but to all individuals, favoring a life-course and patient-centered approach centered around integrated, community-based care. Public health personnel should be trained to address frailty not merely from a clinical perspective, but also in a societal context. Interventions should be delivered in the individuals' environment and within their social networks. Furthermore, public health professionals should contribute to education and training on frailty at a community level, fostering community-based interventions to support older adults and their caregivers to prevent and manage frailty. The purpose of this paper is to offer an overview of the concept of frailty for a public health audience in order to raise awareness of the multidimensional aspects of frailty and on how these should be addressed using an integrated and holistic approach to care.
在全球范围内，预期寿命正在延长。然而，获得的生命年数并不总是与健康生命年数相对应，这可能导致虚弱的增加。鉴于人口老龄化的程度、虚弱与年龄的关系以及虚弱对老年人不良后果的影响，虚弱越来越被认为是一个重大的公共卫生问题。早期发现这种情况对于帮助老年人恢复功能和预防与该综合征相关的不良后果非常重要。尽管诊断虚弱很重要，但对于是否应该常规实施筛查，尚无明确的证据或共识。已经开发了广泛的筛查和评估工具，采用生物心理社会方法，将虚弱描述为一种动态状态，是由于身体、心理和社会领域中的任何一个领域的缺陷导致的，这些缺陷会影响健康。应该使用综合和整体的护理方法来识别和解决虚弱的所有这些方面。为了实现这一目标，公共卫生和初级卫生保健（PHC）需要成为提供护理的支点，不仅为老年人和体弱多病者提供护理，而且为所有个人提供护理，倡导以生命为中心和以患者为中心的方法，以综合、以社区为基础的护理为中心。公共卫生人员应该接受培训，不仅从临床角度，而且从社会角度来解决虚弱问题。干预措施应该在个人的环境中和他们的社交网络中进行。此外，公共卫生专业人员应该在社区一级为虚弱问题的教育和培训做出贡献，促进基于社区的干预措施，以支持老年人及其照顾者预防和管理虚弱。本文的目的是为公共卫生受众提供虚弱概念的概述，以提高对虚弱的多维度方面的认识，以及如何使用综合和整体的护理方法来解决这些问题。
