VA Center of Innovation in Long Term Services, Providence VA Medical Center, Providence, RI; The University of Massachusetts Boston, Department of Gerontology, Boston, MA; Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA.
VA Center of Innovation in Long Term Services, Providence VA Medical Center, Providence, RI; Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, RI.
R I Med J (2013). 2021 May 3;104(4):16-19.
Frailty, a vulnerability to stressors, has been increasingly woven into the clinical understanding of older people who are unable to respond to the impact of diseases, disability, and age-related decline. While the literature has focused on physical frailty, social frailty has been conceptualized within the domains of social needs (social and emotional support, loneliness), resources (income, food, housing, medical care, etc), social fulfillment (engagement in work and activities), and self-management (cognitive function, mental health, advance planning). This review outlines the assessment of the four domains of social frailty within the structure of clinical visits, particularly annual wellness and advance care planning. Increasing connectivity with the community, health system, and government support is the primary recommended intervention. On a policy level, expanding opportunities to connect socially frail people with resources may help mitigate the vulnerability of physical frailty.
虚弱是对压力源的脆弱性,它已逐渐被纳入对无法应对疾病、残疾和与年龄相关的衰退影响的老年人的临床理解中。虽然文献主要关注身体虚弱,但社会虚弱已在社会需求(社会和情感支持、孤独)、资源(收入、食物、住房、医疗保健等)、社会实现(参与工作和活动)和自我管理(认知功能、心理健康、提前规划)领域内进行了概念化。本综述概述了在临床访视结构内评估社会虚弱的四个领域,特别是年度健康检查和预先护理计划。增加与社区、卫生系统和政府支持的联系是主要推荐的干预措施。在政策层面上,扩大使社会虚弱的人与资源建立联系的机会可能有助于减轻身体虚弱的脆弱性。