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[处于恢复力与内在能力交界的脆弱性]

[Frailty at the interface of resilience and intrinsic capacity].

作者信息

Rippl Michaela, Polidori Cristina, Drey Michael

机构信息

Medizinische Klinik und Poliklinik IV, Geriatrie, LMU Klinikum München, Ziemssenstr. 5, 80336, München, Deutschland.

Klinik II für Innere Medizin, Universitäre Altersmedizin, Universitätsklinik Köln, Köln, Deutschland.

出版信息

Inn Med (Heidelb). 2025 Aug 22. doi: 10.1007/s00108-025-01979-1.

Abstract

BACKGROUND

Various concepts are used to assess the health status of geriatric patients, including frailty, resilience, and intrinsic capacity. Frailty, as the oldest and best-known concept among these, focuses on identifying functional deficits, whereas resilience and intrinsic capacity primarily assess preserved abilities. The application of all these concepts supports risk stratification and therapy planning in older patients.

OBJECTIVES

The aim of the present work is to systematically present intrinsic capacity and resilience as well as their relationship to and distinguishing characteristics from frailty. Additionally, intrinsic capacity and resilience are here considered within the framework of specific and overlapping features, as well as differences and practical relevance for geriatric care.

MATERIAL AND METHODS

A narrative analysis of the concepts was conducted based on current literature.

RESULTS

Content overlap between frailty, intrinsic capacity and resilience, particularly in the domains of mobility and mental abilities, is present. Since most concepts emphasize only one thematic focus, multidimensional models, such as intrinsic capacity, can be advantageous. Different versions of measurement tools, especially for frailty, exist for different clinical settings. To date, no standardized measurement tools of frailty, intrinsic capacity, and resilience have been universally recommended.

CONCLUSION

All concepts play an important role in the clinically meaningful stratification of older adults. In clinical practice, it is recommended to select one concept based on the parameters to be evaluated and to apply it consistently across all assessment time points.

摘要

背景

多种概念被用于评估老年患者的健康状况,包括衰弱、恢复力和内在能力。衰弱是其中最古老且最广为人知的概念,侧重于识别功能缺陷,而恢复力和内在能力主要评估保留的能力。所有这些概念的应用都有助于老年患者的风险分层和治疗规划。

目的

本研究的目的是系统地介绍内在能力和恢复力,以及它们与衰弱的关系和区别特征。此外,本文将在特定和重叠特征的框架内考虑内在能力和恢复力,以及它们在老年护理中的差异和实际相关性。

材料与方法

基于当前文献对这些概念进行了叙述性分析。

结果

衰弱、内在能力和恢复力之间存在内容重叠,尤其是在 mobility 和心理能力方面。由于大多数概念仅强调一个主题重点,因此像内在能力这样的多维模型可能具有优势。针对不同的临床环境,存在不同版本的测量工具,尤其是针对衰弱的工具。迄今为止,尚未普遍推荐用于衰弱、内在能力和恢复力的标准化测量工具。

结论

所有概念在老年人具有临床意义的分层中都发挥着重要作用。在临床实践中,建议根据要评估的参数选择一个概念,并在所有评估时间点一致应用。

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