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Frailty

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Primary Care Mental Health in Older People

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Abstract

Frailty is a common clinical syndrome in older adults, usually resulting from the accumulation of decline in physiological processes, function, and reserve in multiple organs or systems. Its prevalence among community-dwelling older adults ranges from 5% to 7% in persons aged 65–74 years to more than 20% in those aged 85 years and over. Through increased vulnerability to stressors, frailty is associated with numerous adverse outcomes such as falls, functional decline, hospital admission, nursing home admission, and death. The frailty process often remains undetected until later stages, when reversibility is no longer possible. Therefore, several definitions of frailty have been proposed, without reaching consensus, and most are too cumbersome to be implemented in clinical routine. Thus, another way of screening for frailty in practice is to rely on comprehensive geriatric assessment. The comprehensive geriatric approach, although not specific to frailty, allows setting up interventions targeting underlying health problems related to frailty and has shown beneficial in preventing the occurrence and consequences of this syndrome. Among specific interventions tested to prevent or reverse frailty, exercise and, to a lesser extent, nutrition appear as the most effective ones, while no pharmacological treatment showed conclusive benefit.

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Abbreviations

HR:

Hazard ratio (from Cox proportional models analysis)

OR:

Odds ratio (from logistic regression analysis)

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Author information

Authors and Affiliations

  1. Service of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, University of Lausanne Medical Center (CHUV), Lausanne, Switzerland

    Christophe J. Büla & Laurence Seematter Bagnoud

  2. Unit of Geriatric Psychiatry, Sagrat Cor Hospital, Barcelona, Spain

    Manuel Sanchez Perez

  3. Institute of Social and Preventive Medicine, University of Lausanne Medical Center (CHUV), Lausanne, Switzerland

    Laurence Seematter Bagnoud

Authors
  1. Christophe J. Büla
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  2. Manuel Sanchez Perez
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  3. Laurence Seematter Bagnoud
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Corresponding author

Correspondence to Christophe J. Büla .

Editor information

Editors and Affiliations

  1. Unité de Psychiatrie et de Psychothérapie, Centre Les Toises, Lausanne, Switzerland

    Carlos Augusto de Mendonça Lima

  2. Mental Health and Population Health, NOVA University Lisbon, Lisbon, Portugal

    Gabriel Ivbijaro

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Büla, C.J., Perez, M.S., Seematter Bagnoud, L. (2019). Frailty. In: de Mendonça Lima, C., Ivbijaro, G. (eds) Primary Care Mental Health in Older People. Springer, Cham. https://doi.org/10.1007/978-3-030-10814-4_4

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  • DOI: https://doi.org/10.1007/978-3-030-10814-4_4

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