Outcome of interventions in elderly persons classified according to the Fried frailty phenotype: an integrative review

Letice Dalla Lana,Maria Da Graça Oliveira Crossetti

doi:10.1590/1981-22562019022.190008

Abstract

Abstract Objective: To analyze the interventions carried out with elderly persons classified according to the Fried frailty phenotype criteria and the outcomes obtained. Method: The PubMed, Embase, Scopus, CINAHL, PEDro, SciELO, BVS and Web of Science portals were used, and a manual search was applied to identify the interventions implemented in elderly persons aged over 60 years, which were able to modify the scores of the frailty phenotype criteria and other outcomes. Results: The final sample totaled 14 randomized clinical trials published between 2001 and 2018. The combined interventions of exercise, orientation and nutritional supplementation with or without cognitive training presented better outcomes for the frailty criteria and other clinical outcomes in pre-frail and frail elderly persons living in the community and in long-term care facilities. Conclusion: The implementation of combined interventions sustains frailty as a reversible and multifactorial syndrome.

Highlights

Frailty in the elderly, which is one of the geriatric syndromes, is widely understood as a decline in biological reserve, resulting in decreased physiological resistance to stressors[1]
The variables of interest were defined as a proposal, being: frailty conceptualized by Fried et al.[1]; pre-frail elderly persons classified by the presence of one or two frailty phenotype criteria; frail elderly persons classified by the presence of three or more criteria; Intervention characterized by actions that enable outcomes capable of modifying the level of frailty and outcomes as results for the five phenotype criteria and for frailty found following the implementation of the interventions
In Chart 2, we describe the sample of 2,153 prefrail and frail elderly persons, of which 1,363 were female

Summary

Introduction

Frailty in the elderly, which is one of the geriatric syndromes, is widely understood as a decline in biological reserve, resulting in decreased physiological resistance to stressors[1]. In Brazil, the prevalence of pre-frail elderly is 51.0% while that of frail elderly is 11.2%, with walking speed and weakness the phenotype criteria with the greatest chance of leading to the development of frailty[8]. This prevalence may increase, as Brazil is expected to occupy sixth place in the world among the countries with the largest number of elderly people by 20259,10

Methods

Results

Discussion

Conclusion