Need for comprehensive management of frailty at an individual level: European perspective from the advantage joint action on frailty

Abstract

Objectives: ADVANTAGE Joint Action is a large collaborative project co-founded by the European Commission and its Member States to build a common understanding of frailty for Member States on which to base a common management approach for older people who are frail or at risk of developing frailty. One of the key objectives of the project is presented in this paper; how to manage frailty at the individual level. Methods: A systematic review of the literature was conducted, including grey literature and good practices when possible. Results: The management of frailty should be directed towards comprehensive and holistic treatment in multiple and related fields. Prevention requires a multifaceted approach addressing factors that have resonance across the individual’s life course. Comprehensive geriatric assessment to diagnose the condition and plan a personalized multidomain treatment increases better outcomes. Multicomponent exercise programmes, adequate protein and vitamin D intake, when insufficient, and reduction in polypharmacy and inadequate prescription, are the most effective strategies found in the literature to manage frailty effectively. Conclusion: Frailty can be effectively prevented and managed with a multidomain intervention strategy based on comprehensive geriatric assessment.

Keywords

• frailty
• management
• prevention
• treatment
• comprehensive geriatric assessment
• advantage joint action