Abstract
The concept of frailty syndrome (FS) was first described in the scientific literature three decades ago. For a very long time, we understood it as a geriatric problem, recently becoming one of the dominant concepts in cardiology. It identifies symptoms of FS in one in 10 elderly people. It is estimated that in Europe, 17% of elderly people have FS. The changes in FS resemble and often overlap with changes associated with the physiological aging process of the body. Although there are numerous scientific reports confirming that FS is age correlated, it is not an unavoidable part of the aging process and does not apply only to the elderly. FS is a reversible clinical condition. To maximize benefits of frailty-reversing activities for patient with frailty, identification of its determinants appears to be fundamental. Many of the determinants of the FS have already been known: reduction in physical activity, malnutrition, sarcopenia, polypharmacy, depressive symptom, cognitive disorders, and lack of social support. This review shows that insight into FS determinants is the starting point for building both the comprehensive definition of FS and the adoption of the assessment method of FS, and then successful clinical management.
Highlights
There are an increasing number of research reports on frailty syndrome (FS) showing its importance in cardiology and evidence-base clinical practice
It seems that the adoption of a multidimensional definition is promising, because it ends up with the practical tool in designing strategies and interventions to prevent the development of frailty
Knowledge of individual FS determinants is important for clinicians in identifying individual patient’s needs, adapting to them therapeutic strategies, risk stratification, clinical decisionsmaking, and building programs that would reverse symptoms of FS and reduce the medical, psychological, social, and economic costs incurred for the adverse consequences of FS
Summary
There are an increasing number of research reports on frailty syndrome (FS) showing its importance in cardiology and evidence-base clinical practice. Despite the widespread importance of FS in clinical management, there are no explicit cardiological guidelines adopting a specific definition of FS and requirements for applying methods of its identification (Vogt et al, 2018). There are no standardized methods in clinical decisions-making based on FS, as it is still being diagnosed with the patient’s foot-of-the-bed assessment or the so-called “eyeball test” (Bridgman et al, 2015). The Task Force of the International Conference of Frailty and Sarcopenia Research (ICFSR) has developed clinical practice guidelines for identification and management of physical frailty. These recommendations recognize that older adults over age 65 should be screened for FS rapidly based on the validated instrument adapted for the specific patient’s conditions. All patients who passed a positive screening test for frailty and patients classified as pre-frail should receive further assessments for clinical frailty (Dent et al, 2019)
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