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The Frailty Challenge: Identifying early markers of physical frailty in the oldest old Host Publication: MICRA PhD Conference Program 14 May 2015 in association with age UK and the social and behavioural section of the International association of geriatrics and gerontology - European region Authors: S. Vermeiren, A. Habbig, R. Vella Azzopardi, A. Scafoglieri, B. Jansen and I. Bautmans Publication Year: 2015
Abstract: Background: The ageing world population brings along many challenges. Active ageing and independent living is the way forward to reduce the burdens of an ageing population. One of the most prominent barriers to active ageing is frailty, recognised as a major geriatric syndrome. The consensus and operationalisation of frailty and pre-frailty still lacks consensus. Fried’s Phenotype (FP), the most accepted frailty approach (2029 WoS citations), consists of 5 components: exhaustion, weight loss, low physical activity, slow walking speed and low grip strength. Pre-frail elderly, defined as an incomplete FP (only 1DŽ criteria), are not well described in literature. As an “absolute reserve capacity” approach, FP defines frailty as meeting 3 or more and robust as meeting 0 deficits (figure 1). Since maximal absolute reserve capacity at young age varies considerably amongst individuals, it remains unclear where to draw the line between robust and early frailty (when deficits are not yet apparent). This project, with a focus on physical frailty, is part of a larger multidisciplinary project, exploring frailty in multiple domains (medical, psychosocial, cognitive, environmental).Objectives: Notwithstanding frailty is linked to several domains (social, medical, psychological, etc.), the physical aspect of frailty is a dominating component, which is reflected by the fact that a loss in physical reserve capacity is an indispensable component of all comprehensive frailty scales that exist today. The objective of this study is to identify the early markers of physical frailty in order to enable the oldest old to remain independent as long and as good as possible.Thisproject introduces a new concept of “relative reserve capacity”, reflected by aloss over time. Above 80, loss rates of 2%/year reflect biological ageing. Weconsider higher loss in relative reserve capacity (e.g. 10%) an early sign offrailty, which can occur without changes in FP- score (which will appear later,when reversibility is more challenging) (figure 1). To detect elderly withoutdeficits, but showing excessive loss in reserve capacity, sensitive andresponsive measures covering the 5 components of FP are used in the study. Methods: We target the (apparently) robust elderly and will calculate the odds for developing (pre)frailty over 2 years for the robust, showing high loss compared to those with normal loss in relative reserve.Future plans: The results of this study will allow for a better understanding of the mechanisms by which elderly persons develop pre-frailty and frailty, and will enable us in the future to develop new interventions to prevent or delay the occurrence of frailty in the oldest old. More participants will be recruited and results will be translated into scientific publications on frailty.
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