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衰弱:一个新兴的公共卫生重点。

Frailty: An Emerging Public Health Priority.

机构信息

Gérontopôle, University Hospital of Toulouse, Toulouse, France; INSERM UMR1027, University of Toulouse III Paul Sabatier, Toulouse, France.

Institute of Psychiatry, King's College, London, United Kingdom.

出版信息

J Am Med Dir Assoc. 2016 Mar 1;17(3):188-92. doi: 10.1016/j.jamda.2015.12.016. Epub 2016 Jan 21.

Abstract

The absolute and relative increases in the number of older persons are evident worldwide, from the most developed countries to the lowest-income regions. Multimorbidity and need for social support increase with age. Age-related conditions and, in particular, disabilities are a significant burden for the person, his or her family, and public health care systems. To guarantee the sustainability of public health systems and improve the quality of care provided, it is becoming urgent to act to prevent and delay the disabling cascade. Current evidence shows that too large a proportion of community-dwelling older people present risk factors for major health-related events and unmet clinical needs. In this scenario, the "frailty syndrome" is a condition of special interest. Frailty is a status of extreme vulnerability to endogenous and exogenous stressors exposing the individual to a higher risk of negative health-related outcomes. Frailty may represent a transition phase between successful aging and disability, and a condition to target for restoring robustness in the individual at risk. Given its syndromic nature, targeting frailty requires a comprehensive approach. The identification of frailty as a target for implementing preventive interventions against age-related conditions is pivotal. Every effort should be made by health care authorities to maximize efforts in this field, balancing priorities, needs, and resources. Raising awareness about frailty and age-related conditions in the population is important for effective prevention, and should lead to the promotion of lifelong healthy behaviors and lifestyle.

摘要

全球范围内,无论是在最发达的国家还是在低收入地区,老年人口的绝对和相对数量都在增加。随着年龄的增长,多病共存和对社会支持的需求增加。与年龄相关的疾病,特别是残疾,给个人、家庭和公共医疗保健系统带来了巨大的负担。为了保障公共医疗保健系统的可持续性并提高提供的护理质量,采取行动预防和延缓致残性疾病的发生已迫在眉睫。目前的证据表明,太多的社区居住的老年人存在与主要健康相关事件和未满足的临床需求相关的风险因素。在这种情况下,“虚弱综合征”是一种特别值得关注的情况。虚弱是一种极易受到内源性和外源性压力源影响的状态,使个体面临更高的负面健康相关结果的风险。虚弱可能代表着成功老龄化和残疾之间的过渡阶段,是恢复个体韧性的目标状态。鉴于其综合征性质,针对虚弱需要采取综合方法。确定虚弱作为预防与年龄相关疾病的干预措施的目标至关重要。医疗保健当局应尽一切努力在这一领域最大限度地发挥作用,平衡优先事项、需求和资源。提高公众对虚弱和与年龄相关疾病的认识对于有效预防至关重要,并应促使人们终身保持健康的行为和生活方式。

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