Social Impact of Clinical Frailty in Older Adults
Keywords:
older adults; frailty; social impact.Abstract
ABSTRACT
Introduction: The rapid aging of today's society represents a reality that influences the lives of the modern population. Frailty syndrome is a geriatric syndrome characterized by decreased functional reserve, which increases a person's vulnerability and an inadequate response to all types of stress. Aging and clinical frailty are associated, but are distinct. The diagnosis of frailty is primarily based on clinical aspects, and frailty is linked to a large number of pathologies.
Objective: To analyze the social impact of clinical frailty in older adults.
Methods: Theoretical-historical-logical, analytical-synthetic, and documentary review methods were used.
Development: Frailty has been linked to several factors such as comorbidity, polypharmacy, disability, dependency, institutionalization, hospitalization, and death. The family is the main link in social support for frail older adults, providing both emotional and protective functions.
Conclusions: Clinical frailty is a pathology that, when associated with older adults, negatively impacts their health and their families. This leads to increased use of social and healthcare resources, which leads to increased costs for patients, families, and healthcare services.
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References
OMS. “Envejecimiento y salud,” October 1, 2022. https://www.who.int/es/news-room/fact-sheets/detail/ageing-and-health.
Vellas BJ, Wagne JS, Romero L, Baumgarten RN, Rubenstein LZ, Garry PJ. One-leg balance is an important predictor of injurious falls in older persons. J Am Geriatr Soc. 1997;45:735-8.
Castelblanque E, Albert Cuñat V. ¿Quiénes son los ancianos frágiles ancianos de riesgo? Estudio en personas mayores de 65 años del Área Sanitaria de Guadalajara. Medicina General. 2002;45:443-680. [ Links ]
Olde Rikkert MG, Rigaud AS, van Hoeyweghen RJ, et al. Geriatric syndromes: medical misnomer or progress in geriatrics? Neth J Med. 2003;61(3):83-7. Acceso: 25/012/2021. Disponible en: https://pubmed.ncbi.nlm.nih.gov/12765229/
Kaur P, Rowland J, Whiting E. The ABCD of the comprehensive geriatric assessment. Med J Aust. 2021;215(5):206-7 e1. Acceso: 08/09/2021. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/34365650/
Isaacs B, Gunn J, MacKechan A, et al. The concept of pre-death. Lancet 1971;1(7709):1115-8. Acceso: 25/012/2021. Disponible en: https://pubmed.ncbi.nlm.nih.gov/4102635/
Boccardi V, Marano L. The Geriatric Surgery: The Importance of Frailty Identification Beyond Chronological Age. Geriatrics (Basel). 2020;5(1):12. doi: 10.3390/geriatrics5010012. Acceso: 08/09/2021. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/32121144
Buchner DM, Wagner EH. Preventing frail health. Clin Geriatr Med. 1992; 8:1-17. [ Links ]
Brocklehurst JC. The geriatric sevice and the day hospital. In: Brocklehurst JC, editor.Texbook of geriatric medicine and gerontology. 3th ed. Edinburg: Churchill- Livingstone;1985.p.982-95. [ Links ]
Campbell AJ, Buchner DM. Unstable disability and the fluctuations of frailty. Age and ageing. 1997;26:315-8. [ Links ]
Batzán Cortés JJ. Atención sanitaria al anciano frágil: de la teoría a la evidencia científica. Med Clín. 2000;115 (NM 18):707-17. [ Links ]
Brown I, R enwick R, Raphael D. Frailty: constructing a common meaning, definition, and conceptual framework. Int J Rehabil Research. 1995;18:93-102. [ Links ]
Powell C. Frailty: help or hindrance? J R Soc Med. 1997;90( Suppl):23-6. [ Links ]
Fried LP. Frailty. In: Hazzard WR, Bierman EL, Blass SP, editors. Principles of Geriatric and Gerontology. 3th ed. Nueva York: McGraw Hill;1994.p.1149-56. [ Links ]
Strawbridge WJ, Shema SJ, Balfour JL, Higby HR, Kaplan GA. Antecedents of frailty over three decades in an older cohort. J Gerontol B Psychol Sci Soc Sci. 1998;53:S9-16. [ Links ]
Rockwood K, Fox RA, Stolee P, Robertson D, Beattie BL. Frailty in elderly people: an evolving concept. CMAJ. 1994;150:489-95. [ Links ]
Chin A Paw MJ, de Groot LC, van Gend SV, Schoterman MH, Schouten EG, Schroll M, et al. Inactivity and weight loss: effective criteria to identify frailty. J Nutr Health Aging. 2003;7:55-60.
Manual de la Organización Panamericana de la Salud para la atención al adulto mayor. Washington: OPS;2003.
Castelblanque E, Albert Cuñat V. ¿Quiénes son los ancianos frágiles –ancianos de riesgo? Estudio en personas mayores de 65 años del Área Sanitaria de Guadalajara. Medicina General. 2002;45:443-680.
Fried LP, Walston J. Frailty and failure to thrive. In: Hazzard WR, Blass JP, Ettinger WH, Halter JB, Ouslander JG, editors. Principles of geriatric medicine and gerontology. 4th ed. Nueva York: McGraw-Hill;1999.p.1387-402.
Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol Am Biol Sci Med Sci. 2004;59: 55-63.
Lipsitz LA, Goldberger AL. Loss of complexity'' and aging. Potential applications of fractals and chaos theory to senescence. JAMA. 1992;267:1806–9.
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001; 56 (3): M146-56. doi: 10.1093/gerona/56.3.m146. [ Links ]
Lipsitz LA. Physiological complexity, aging and the path to frailty [review]. Sci Aging Knowledge Environ. 2004;16.
Mitnitski AB, Song X, Rockwood K. The estimation of relative fitness and frailty in community-dwelling older adults using self-report data . J Gerontol Am Biol Sci Med Sci. 2004;59:M627-32.
Song X, Mitnitski A, MacKnight C, Rockwood K. Assessment of individual risk of death using self-report data: an artificial neural network compared with a frailty index. J Am Geriatr Soc. 2004;52:1180-4.
Carpeta Metodológica. Adultos mayores frágiles [serie en Internet]. [citada 2005]. Disponible en: http://aps.sld.cu/bvs/materiales/carpeta/carpeta.html
Freitag S, Schmidt S, Gobbens R. "Tilburg frailty indicator." Zeitschrift für Gerontologie und Geriatrie 2016; 49: 86-93. DOI: 10.1007/s00391-015-0889-9. [ Links ]
González Rodríguez Raidel, Cardentey García Juan, Hernández Díaz Delia de la Caridad, Rosales Álvarez Giselys, Jeres Castillo Carlos Miguel. Comportamiento de la fragilidad en adultos mayores. AMC [Internet]. 2017 Ago [citado 2024 Ene 03] ; 21( 4 ): 498-509. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1025-02552017000400008&lng=es.
Carrasco G., Marcela. “Fragilidad: Un Síndrome Geriátrico En Evolución.” Accessed January 3, 2024. https://medicina.uc.cl/publicacion/fragilidad-sindrome-geriatrico-evolucion/.
Rodríguez Jiménez, Klara S; Reales Chacón, Lisbeth J. Síndrome de fragilidad y sus variables asociadas. Med. interna (Caracas) ; 32(4): 272-278, 2016.
Linda P Fried, Ligias Ferrucci, Jonathan Darer, Jeff D. Williamson, Gerard Anderson. Untangling the concept of Disability. , Frailty, and Comorbilidity: Implications for Improved Targeting and Care. Jornal oh Gerontology: Medical Sciences 2004; 59: 255-26
Caridad, Roxina, and García Jiménez. “Polifarmacia como indicador de fragilidad segúnla esfera biofuncional en pacientes mayores.,” 2021. https://gerathabana2021.sld.cu/index.php/gerathabana/2021/paper/view/57.
Ramírez A., Ramírez J.P., Borrell Zayas JC. Polifarmacia e interacciones medicamentosas potenciales en el adulto mayor, una polémica en la prescripción. Revista Cubana de Farmacia. 2019; 52(2):e335. pág. 5- 9
Escobedo Martínez E.F. Asociación de polifarmacia y comorbilidad en adultos mayores de la unidad de medicina familiar n. 47 en San Luis Potosí. Universidad Autónoma de San Luis Potosí. Repositorio institucional 2018. (Citado 6 de octubre del 2021).
Hernández Ugalde F, Álvarez Escobar MC, Martínez Leyva G, Junco Sánchez VL, Valdés Gasmury I, Hidalgo Ruiz M. Polifarmacia en el anciano. Retos y soluciones. Rev. Med. Electrón. 2018 [citado 15/9/2021]; 40(6):2053- 70. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S16841824201800060205 3&lng=es3
Maher, R. L., Hanlon, J. T., & Hajjar, E. R. (2014). Clinical Consequences of Polypharmacy in Elderly. Expert Opinion on Drug Safety, 13(1), 57–65.
Ramírez Pérez AR, Furones Mourelle JA, Ramos Cedeño AM, Ramírez Pérez JF., Valladares Mas FC. Polifarmacia y complejidad farmacoterapeutica en pacientes de hogares de ancianos en Cienfuegos. Revista habanera de ciencias médicas, vol. 20, núm. 3, e3643, 2021. (Citado el 4 de octubre de 2021).
Casas-Vásquez, P., Ortiz-Saavedra, P., & Penny-Montenegro, E. (2016). Estrategias para optimizar el manejo farmacológico en el adulto mayor. Revista Peruana de Medicina Experimental Y Salud Pública, 33(2), 335. https://doi.org/10.17843/rpmesp.2016.332.2153
Alfonso Figueroa L, Soto Carballo D, Santos Fernández NA. Calidad de vida y apoyo social percibido en adultos mayores. Rev Ciencias Médicas [Internet]. 2016 Feb [citado 21 Jul 2020];20(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S156131942016000100012&lng=es
Daniel B. Kaplan. PhD, LICSW, Adelphi University School of Social Revisado/Modificado abr. 2023? Disponible en https://www.msdmanuals.com/es/professional/geriatr%C3%ADa/aspectos-sociales-en-los-ancianos/cuidado-del-anciano-por-parte-de-su-familia
Caregiving the U.S 2020:A Cfocused loor at familia caregivers of adulto age 50+. Tha nacional Aliance for Caregiving, 2020. Accedido 24-3-23
OrtmanJM, VelkoffVA, Hogan H: an aging nation: the older population in the United State. Current Population Reports, 2024.
Beach SR, SchulzR, Donovan H, et al: Family Caregiving during the COVID 19 pandemic. Gerontologist 61(5):650-660, 2021 doi
García López LE,Boyeros Fernández I,Quevedo NavarroM,Alonso CorderoME.Fragilidad, nivel funcional y funcionamiento familiar en adultos mayores.Medimay [Internet]. 2020 [citado: fecha de citado];27(3):339-55. Disponible en: http://revcmhabana.sld.cu/index.php/rcmh/article/view/1733
Gonçalves LHT, Costa MAM, Martins MM, Nassar SM, Zunino R. La dinámica de la familia de ancianos con edad avanzada en el contexto de la ciudad de Porto, Portugal. Rev. Latino-Am. Enfermagem [Internet]. mayo-jun. 2011
Passanante, María Inés (comp.). Familia y ancianidad : aprendiendo a aceptar los años y a acompañar a nuestros mayores [en línea]. Buenos Aires : Educa, 2015. (Familia, Escuela de Humanidad ; n. 14) Disponible en: http://bibliotecadigital.uca.edu.ar/repositorio/libros/familia-ancianidad-nuestros-mayores.pdf
CELADE., Centro Latinoamericano y Caribeño de Demografía. Los adultos mayores en América Latina y el Caribe. Datos e indicadores. Madrid: Boletín informativo, edición especial con ocasión de la II asamblea mundial de Naciones Unidas sobre el envejecimiento, 1-79, CELADE/CEPAL, Santiago de Chile, Chile, (2002) [ Links ]
Quispe-Fernández, Gabith M., Dante Ayaviri-Nina, Pablo Djabayan-Djibeyan, Otto Arellano-Cepeda, Gabith M. Quispe-Fernández, Dante Ayaviri-Nina, Pablo Djabayan-Djibeyan, and Otto Arellano-Cepeda. “El Costo de La Salud En Adultos Mayores: Un Estudio Descriptivo y Retrospectivo En Ecuador.” Información Tecnológica 32, no. 5 (October 2021): 75–90. https://doi.org/10.4067/S0718-07642021000500075.
Bail, K., Draper, B., y otros tres autores, Predicting excess cost for older inpatients with clinical complexity: a retrospective cohort study examining cognition, comorbidities, and complications, https://doi.org/10.1371/journal.pone.0193319, PLoS One, 13(2), e0193-319 (2018) [ Links ]
Wittenberg, R., Hu, B., y otros siete autores, Projections of care for older people with dementia in England: 2015 to 2040, https://doi.org/10.1093/ageing/afz154, Age Ageing, 49(2), 264-269 (2020) [ Links ]
Florence, C.S., Bergen, G., y otros cuatro autores, Medical costs of fatal and nonfatal falls in older adults, https://doi.org/10.1111/jgs.15304, J. Am. Geriatr. Soc., 66(4), 693-698 (2018) [ Links ]
Rechel, B., Grundy, E., y otros cinco autores, Ageing in the European Union, https://doi.org/10.1016/S0140-6736(12)62087-X, Lancet, 381(9874), 1312-1322 (2013) [ Links ]
Katon, W.J., Lin, E., y otros dos autores, Increased medical costs of a population-based sample of depressed elderly patients, https://doi:10.1001/archpsyc.60.9.897, Arch Gen Psychiatry, 60(9), 897-903 (2003) [ Links ]
Gnanamanickam, E.S., Dyer, S.M., y otros diez autores, Direct health and residential care costs of people living with dementia in Australian residential aged care, https://doi.org/10.1002/gps.4842, Int. J. Geriatr. Psychiatry, 33(7), 859-866 (2018) [ Links ]
Thavorn, K, Maxwell, C.J., y otros seis autores, Effect of socio-demographic factors on the association between multimorbidity and healthcare costs: a population-based, retrospective cohort study, http://dx.doi.org/10.1136/bmjopen-2017-017264, BMJ Open 7(8), e017-264 (2017) [ Links ]
Alonso Galbán Patricia, Sansó Soberats Félix José, Díaz-Canel Navarro Ana María, Carrasco García Mayra, Oliva Tania. Envejecimiento poblacional y fragilidad en el adulto mayor. Rev Cubana Salud Pública [Internet]. 2007 Mar [citado 2024 Ene 03] ; 33( 1 ). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-34662007000100010&lng=es.
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