Perceptions and experiences of frailty interventions: quantitative and qualitative results from a survey of partners within the European Innovation Partnership on Active and Healthy Ageing (EIP-AHA)

Holly Gwyther,Rachel Shaw,Maura Marcucci,Carol Holland,Richard Cooke,Antonio Cano

doi:10.1017/s0144686x17000265

Abstract

ABSTRACTThe European Innovation Partnership on Active and Healthy Ageing (EIP-AHA) was launched by the European Commission in 2011 to promote innovation in ageing research. This paper explores the experiences of partners delivering frailty interventions within Europe, registering their programmes with the EIP-AHA. Data were collected using an online survey from 21 partners in seven countries. A mixed-method approach was used with inductive thematic analysis of free-text responses to improve data richness. Responses indicated that there was a lack of consistency between EIP-AHA partners in methods of defining, screening and measuring for frailty and pre-frailty. Open responses to survey questions about intervention facilitators, moderators and barriers were coded into two themes: working with stakeholders and project management. We concluded that EIP-AHA partners are providing interventions addressing physical, cognitive and wellbeing elements of frailty. However, there needs to be an increase in the proportion of interventions that consistently apply valid methods of screening and/or measuring frailty and pre-frailty. Most, but not all projects are targeting pre-frail older adults, suggesting an appropriate balance of prevention in a useful ‘intervention window’ but also a growing understanding that frailty at later stages is amenable to intervention. Findings suggest design manipulations to improve outcomes and adherence to interventions, specifically inclusion of a perceived benefit/reward for older adults, e.g. a social aspect or health-care promotion.

Highlights

This paper explores the progress made in ageing and frailty research by partners within the EIP-AHA, with the aim of synthesising and sharing learning experiences to enable best practice in future frailty-based research and interventions
The CSHA (Rockwood and Mitnitski ), proposes that frailty is measured as a risk state in terms of the number of health ‘deficits’ that are manifest in the individual
There was no consistent method of screening for or measuring frailty; . per cent looked for pre-frail individuals or ‘people at risk of becoming frail’

Summary

Introduction

FrailtyFrailty is a multi-dimensional clinical condition characterised by decreased physiological resilience and a weakened response to stressors (RodríguezMañas et al ). Fried’s phenotype (Fried et al , ) describes frailty as a biological syndrome resulting from deficits in five physiological domains: muscle weakness, slowness, exhaustion, low physical activity and unintentional weight loss. The CSHA (Rockwood and Mitnitski ), proposes that frailty is measured as a risk state in terms of the number of health ‘deficits’ that are manifest in the individual. This model incorporates physical weakness and polypharmacy, cognition, mental health and activities of daily living constructs. Frailty has been acknowledged as a multi-dimensional concept (Rodríguez-Mañas et al ; Walston et al ) that includes psychological elements, as well as social elements such as lack of social contacts, situational factors and/or support

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Discussion

Conclusion