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护理学报 ›› 2021, Vol. 28 ›› Issue (15): 69-73.doi: 10.16460/j.issn1008-9969.2021.15.069

• 临床护理:老年护理 • 上一篇    下一篇

2020年ICFSR共识指南解读及对我国预防和管理老年人衰弱的启示

陈玉华1, 张兵2, 谢娟3, 唐荣荣3   

  1. 1.江苏省南通卫生高等职业技术学校 护理系,江苏 南通 226010;
    2.南通市医疗保障局,江苏 南通 226001;
    3.南通大学医学院,江苏 南通 226001
  • 收稿日期:2021-03-23 出版日期:2021-08-10 发布日期:2021-09-10
  • 通讯作者: 张兵(1969-),男,江苏南通人,本科学历,研究员。E-mail:1301842216@qq.com
  • 作者简介:陈玉华(1969-),女,江苏南通人,本科学历,副教授,教学督导。
  • 基金资助:
    南通市科技项目-社会民生科技-重点-其他领域(MS22020007)

Interpretation of 2020 ICFSR Consensus Guidelines and Implications for Prevention and anagement of Frailty in Elderly People in China

CHEN Yu-hua1, ZHANG Bing2, XIE Juan3, TANG Rong-rong3   

  1. 1. Dept. of Nursing, Nantong College of Health, Nantong 226010, China;
    2. Nantong Healthcare Security Bureau, Nantong 226001, China;
    3. Nantong University School of Medicine,Nantong 226001, China
  • Received:2021-03-23 Online:2021-08-10 Published:2021-09-10

摘要: 目的 解读国际衰弱和肌肉减少症研究会议(International Conference of Frailty and Sarcopenia Research,ICFSR)新发布的《基层医疗中衰弱患者筛查和管理共识指南》,为我国预防和管理老年人衰弱提供参考。方法 通过翻译和阅读《基层医疗中衰弱患者筛查和管理共识指南》及相关领域的文献,对其进行解读。结果 《基层医疗中衰弱患者筛查和管理共识指南》从基层医疗的角度推荐了7种衰弱筛查工具和3种衰弱管理模式。结论 我国对衰弱的研究尚处于初级阶段,社会对于老年人的衰弱现象尚未引起足够的重视。今后可探索和发展适合我国的衰弱预防和管理方法,以不断推进健康老龄化发展。

关键词: 基层医疗, 老年人, 衰弱, 管理, 指南

Abstract: Objective To interpret the new ICFSR Consensus Guidelines on Screening and Management of Frailty Patients in Primary Care, and to provide reference for the prevention and management of frailty in the elderly in China. Methods The Consensus Guidelines for Screening and Management of Frailty Patients in Primary Care and related literatures were translated and reviewed, then the guidelines were interpreted. Results The Consensus Guidelines for Screening and Management of Frailty Patients in Primary Care recommended 7 frailty screening tools and 3 frailty management modes for primary care. Conclusion The research on frailty in China is still in the primary stage. In the future, we can explore and develop appropriate frailty prevention and management methods to continuously promote the development of healthy aging.

Key words: primary care, elderly, frailty, management, guideline

中图分类号: 

  • R473.2
[1] Dent E, Morley JE, Gruz-Jentoft AJ, et al.Physical Frailty: ICFSR International Clinical Practice Guidelines for Identification and Management[J]. J NutrHealth Aging, 2019,23(9):771-787.DOI:10.1007/s12603-019-1273-z.
[2] Ruiz JG, Dent E, Morley JE, et al.Screening for and Managing the Person with Frailty in Primary Care: ICFSR Consensus Guidelines[J]. J Nutr HealthAging,2020,24(9):920-927.DOI:10.1007/s12603-020-1492-3.
[3] 中华医学会老年医学分会.老年患者衰弱评估与干预中国专家共识[J].中华老年医学杂志,2017,36(3):251-256.DOI:10.3760/cma.j.issn.0254-9026.2017.03.007.
[4] Morley JE, Vellas B, van Kan GA, et al. Frailty Consensus: A Call to Action[J]. J Am Med Dir Assoc,2013,14(6):392-397.DOI:10.1016/j.jamda.2013.03.022.
[5] Noguchi N, Blyth FM, Waite LM, et al.Prevalence of the Geriatric Syndromes and Frailty in Older Men Living in the Community: The Concord Healthand Ageing in Men Project[J]. Australas J Ageing,2016, 35(4):255-261.DOI:10.1111/ajag.12310.
[6] 钱军程,陈育德,饶克勤,等.中国老年人口失能流行趋势的分析与建议[J].中国卫生统计,2012, 29(1):6-9.DOI:10.3969/j.issn.1002-3674.2012.01.002.
[7] 李利平,孙建萍.老年慢性病患者失能预防的研究进展[J].护理学杂志,2018,33(21):100-105.DOI:10.3870/j.issn.1001-4152.2018.21.100.
[8] Boyd CM, Fortin M.Future of Multimorbidity Research: How Should Understanding of Multimorbidity Inform Health System Design?[J]. Public Health Reviews, 2010, 32(2):451-474.DOI:10.1007/BF03391611.
[9] Vetrano DL, Palmer K, Marengoni A, et al.Frailty and Multimorbidity: A Systematic Review and Meta-analysis[J]. J Gerontol A Biol Sci Med Sci, 2019, 74(5):659-666.DOI:10.1093/gerona/gly110.
[10] Fried LP, Ferrucci L, Darer J,et al.Untangling the Concepts of Disability, Frailty, and Comorbidity: Implications for Improved Targeting and Care[J]. J Gerontol A Biol Sci Med Sci,2004,59(3):255-263.DOI:10.1093/gerona/59.3.m255.
[11] Abellan van Kan G, Rolland Y, Bergman H, et al. The I.A.N.A Task Force on Frailty Assessment of Older People in Clinical Practice[J]. J Nutr Health Aging,2008,12(1):29-37.DOI:10.1007/BF02982161.
[12] Malmstrom TK, Miller DK, Morley JE.A Comparison of Four Frailty Models[J]. J Am Geriatr Soc,2014,62(4):721-726.DOI:10.1111/jgs.12735.
[13] Woo J, Leung J, Morley JE.Comparison of Frailty Indicators Based on Clinical Phenotype and the Multiple Deficit Approach in Predicting Mortality and Physical Limitation[J]. J Am Geriatr Soc,2012,60(8):1478-1486. DOI:10.1111/j.1532-5415.2012.04074.x.
[14] Frailty Detection-‘a Game Changer’ for Older Australians[EB/OL][2021-01-01].https://www.agedcareguide.com.au/talking-aged care/frailty-detection-a-game-changer-for-older-australians.
[15] Lourenço RA, Moreira VG, Mello RGBd, et al.Consenso Brasileiro de Fragilidade em Idosos: Conceitos, Epidemiologia e Instrumentos de Avaliação[J]. Geriatrics, Gerontology and Aging,2018,12(2):121-135.
[16] Rockwood K, Song XW,Mitnitski A.Geriatric Medicine and the Care Offrail Elderly People[J]. Chin J Geriatr,2009,28(5):353-361.DOI:10.3760/cma.j.issn.0254-9026.2009.05.001.
[17] Basic D,Shanley C.Frail in an Older Inpatient Population:Using the Clinical Frailty Scale to Predict Patient Outcomes[J]. J Aging Health, 2015, 27(4):670-685.DOI:10.1177/0898264314558202.
[18] Saliba D, Elliott M, Rubenstein LZ, et al.The Vulnerable Elders Survey:A Tool for Identifying Vulnerable Older People in the Community[J]. J Am Geriatr Soc, 2001,49(12):1691-1699.DOI:10.1046/j.1532-5415.2001.49281.x.
[19] Luciani A, Biganzoli L, Colloca G, et al.Estimating the Risk of Chemotherapy Toxicity in Older Patients with Cancer: The Role of the Vulnerable Elders Survey-13(VES-13)[J]. J Geriatr Oncol,2015,6(4):272-279.DOI:10.1016/j.jgo.2015.02.005.
[20] Kenig J, Richter P, Zychiewicz B, et al.Vulnerable Elderly Survey 13 asa Screening Method for Frailty in Polish Elderly Surgical Patient-prospective Study[J]. Pol Przegl Chir. 2014,86(3):126-131.DOI:10.2478/pjs-2014-0024.
[21] 张妍妍,姚俊涛.衰弱筛查工具在老年肿瘤患者中应用的研究进展[J]. 肿瘤学杂志,2020,26(3):245-249.DOI:10.11735/j.issn.1671-170X.2020.03.B016.
[22] Nemoto M, Yabushita N, Kim MJ, et al.Assessment of Vulnerable Older Adults’ Physical Function According to the Japanese Long-term Care Insurance(LTCI) System and Fried’s Criteria for Frailty Syndrome[J]. Arch Gerontol Geriatr,2012,55(2):385-391.DOI:10.1016/j.archger.2011.10.004.
[23] Sewo Sampaio PY, Sampaio RAC, Yamada M, et al.Systematic Review of the Kihon Checklist:Is It a Reliable Assessment of Frailty?[J]. Geriatr Gerontol Int, 2016, 16(8):893-902.DOI:10.1111/ggi.12833.
[24] Ambagtsheer RC, Visvanathan R, Dent E, et al.Commonly Used Screening Instruments to Identify Frailty Among Community-dwelling Older People ina General Practice (Primary Care) Setting: A Study of Diagnostic Test Accuracy[J].J Gerontol A Biol Sci Med Sci, 2020, 75(6):1134-1142.DOI:10.1093/gerona/glz260.
[25] WHO. WHO Guidelines on Integrated Care for Older People(ICOPE)[EB/OL].[2021-01-01].http://www.whoint/ageing/publications/guidelines-icope/en/.
[26] Ma L, Chhetri JK, Chan P,et al.Integrated Care for Older People Screening Tool for Measuring Intrinsic Capacity: Preliminary Findings from ICOPE Pilot in China[J]. Frontiers in Medicine, 2020, 11(7):576079.DOI:10.3389/fmed.2020.576079.
[27] Beard JR, Jotheeswaran AT, Cesari M, et al.The Structure and Predictive Value of Intrinsic Capacity in a Longitudinal Study of Ageing[J]. BMJ Open,2019, 9(11):e026119.DOI:10.1136/bmjopen-2018-026119.
[28] Ensrud KE, Ewing SK, Taylor BC, et al.Comparison of 2 Frailty Indexesfor Prediction of Falls, Disability, Fractures, and Death in Older Women[J]. Arch Intern Med,2008,168(4):382-389.DOI:10.1001/archinternmed.2007.113.
[29] Boyd PJ, Nevard M, Ford JA, et al.The Electronic Frailty Index as an Indicator of Community Healthcare Service Utilisation in the Older Population[J]. Age Ageing,2019,48(2):273-277.DOI:10.1093/ageing/afy181.
[30] Clegg A, Bates C,Young J,et al.Development and Validation of an Electronic Frailty Index Using Routine Primary Care Electronic Health Record Data[J]. Age Ageing,2016,45(3):353-360.DOI:10.1093/ageing/afw039.
[31] Garrard JW, Cox NJ, Dodds RM, et al.Comprehensive Geriatric Assessment in Primary Care: A Systematic Review[J]. Aging Clin Exp Res, 2020, 32(2):197-205.DOI:10.1007/s40520-019-01183-w.
[32] Macdonald SH, Travers J, She EN, et al.Primary Care Interventions to Address Physical Frailty Among Community-dwelling Adults Aged 60 Years or Older: A Meta-analysis[J]. PLoS One, 2020, 15(2):e0228821.DOI:10.1371/journal.pone.0228821.
[33] Feng Z, Lugtenberg M, Franse C, et al.Risk Factors and Protective Factors Associated with Incident or Increase of Frailty among Community-dwelling Older Adults: A Systematic Review of Longitudinal Studies[J]. PLoS One,2017,12(6):e0178383.DOI:10.1371/journal.pone.0178383.
[34] Morley JE, Adams EV.Rapid Geriatric Assessment[J].J Am Med Direc Ass,2015,16(10):808-812.DOI:10.1016/j.jamda.2015.08.004.
[35] Sanford AM, Morley JE, Berg-Weger M, et al.High Prevalence of Geriatric Syndromes in Older Adults[J].PLoS One,2020,15(6):e0233857.DOI:10.1371/journal.pone.0233857.
[36] Merchant RA, Hui RJY, Kwek SC, et al.Rapid Geriatric Assessment Using Mobile App in Primary Care: Prevalence of Geriatric Syndromes and Review of Its Feasibility[J]. Front Med(Lausanne),2020,7:261.DOI:10.3389/fmed.2020.00261.
[37] Takeda C, Guyonnet S, Sumi Y, et al.Integrated Care for Older People and the Implementation in the INSPIRE Care Cohort[J]. J Prev Alzheimers Dis,2020,7(2):70-74. DOI:10.14283/jpad.2020.8.
[38] 常飞飞,陈先辉,王强.美国“以患者为中心的医疗之家”模式发展现状及对我国家庭医生服务的启示[J].中国全科医学, 2017, 20(28):3463-3467. DOI:10.3969/j.issn.1007-9572.2017.00.082.
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