Frailty Older Adult

This article addresses an important issue on how to develop frailty assessment tools in older adults with musculoskeletal disorders. Why is this topic more essential? Frailty has found in various fields of chronic diseases not only in musculoskeletal disorders. I am interested in frailty; however, it is tricky to determine who present frail in older adults having physical function limitation. Therefore, the different among physical function limitation, immobility, and frailty are still hard to justification. For example, older adults having secondary or third osteoarthritis always presents with severe pain at the knee joint. This pain also interferes his/her physical function. The more joints movement, the greater pain emerge. Reducing severe

Recognition, evaluation and treatment of this population requires interdisciplinary approach. The interdisciplinary approach collaborate with various groups to provide adequate resources to the vulnerable population. The internal and external factors impact health status of older adults and contributes to vulnerability risk. The internal factor occur due to physiological changes such as increasing age, gender, sensory impairment, memory impairment, substance abuse along with medical co morbidities, malnutrition, decrease in performance of activity of daily living or dependency on care giver or

Thirdly, selecting feasible and suitable frailty assessment tool is a mandatory in clinical settings. From our findings, multiple tools were applying in this particular population. Those tools had both pros and cons in evaluating frailty in clinical settings. Based on our review, the Fried Frailty Index (Fried Frailty Phenotype) has only five components, but it needs a specific device (hand grip measurement) and well-training personnel for assessment frailty. The accumulation deficits model as Frailty Index (FI) has an advantage on flexibility analysis of preexisting database; however, it has numerous variables and time-consuming for assessing frailty. The patient’s self-reported questionnaire, we found that only Edmonton Frailty Scale (EFS)

Group and Rehab Scale. Despite two of the listed five variables being common to the

The term elderly refers to those who are age sixty-five and older. There are three subsections of the elderly which include the young-old who are age sixty-five to seventy-four, the old-old who are age seventy-five to eighty-four, and the oldest-old who are age eighty-five and older. As the overall age of the United States' population is increasing, known as the graying of America, The current percentage of people sixty-five and older is about twelve percent and is expected to increase significantly over the next twenty years. This increase, cultural changes, and familial changes have led to an increased need of financial resources, legal aide, medical care, and nursing and assisted living facilities for the elderly. Because people are simply living longer than they have before, this puts increased tension on the society as a whole including government programs, legal and protective services, but especially the medical field. Instead of the family taking care of their elderly as in the past, now many of them end up in nursing homes and assisted living facilities.

From our review, there are a few studies of frailty in orthopedic clinical settings. Also, frailty is complex with multidimensional components; there is not enough robust evidence to justify which frailty instrument has the edge over others in clinical settings. However, the reasons to consider for selecting clinical frailty instruments should be concerned with: clinical contexts, conceptual or theoretical framework, validity and reliability of frailty instruments, and predictability of health outcomes. Based on reasons as mentioned, the CHS (Fried’s Frailty Phenotype) and FI (Frailty Index) have more advantage than others. The FI has a strong predictability of the adverse health outcomes, but the cut points vary. Moreover, the comorbidity

even widely controversial debate regarding “a gold standard” of frailty measurement. Also, frailty evaluation in clinical settings has been somewhat restrictive. Owing to the fact that the majority of frailty

For richer or poorer, for sickness and health, until death do us part! These words have become well known in most marriage vows spoken. When vows are taken, couples are not thinking of old age and stressors that may come with aging or the possibility of becoming a caregiver to their spouse in old age. Instead of the fairytale of growing old, holding hands and sitting on the front porch swing, and enjoying grandchildren the reality is one may become ill or have memory issues and the spouse becomes the caregiver and may have to learn to cope with their spouse’s illness.

Frailty is a condition associated with age-related declines, and it has been recognized for many decades. According to an important challenge for aging populations, the term of frailty is widely used in the field of geriatrics and gerontology. It becomes one of the geriatric syndromes, which increases adverse health outcomes. As a concept, it is full of 'known unknowns' such as which mechanisms lead to frailty and how it is best managed or prevent it. In order to examine these circumstances, the current knowledge of understanding frailty characteristics and managing frailty in tangible ways requires an appropriate framing of the problem (Pel-Littel, Schuurmans, Emmelot-Vonk, & Verhaar, 2009).

As individuals age changes occur physiologically that are part of normal aging. These changes occur in all organ systems and can impact an individual’s quality of life. The changes related to aging can be attributed to an individual’s genetic make up, lifestyle, physical activity, and dietary lifestyle. Being able to differentiate between normal changes in aging against disease process is important because it can help clinicians develop a plan of care (Boltz, Capezuti, Fulmer, & Zwicker, 2012). Creating an accurate plan of care for older adults will greatly impact their quality of life.

Frailty is a clinical symptom associated with age-related declines, and it has been recognized as a geriatric syndrome for many decades. According to a major challenge for aging population, the term “frailty” is widely used in the field of geriatrics and gerontology. It is known that frailty has been closely related to older adults who have complex health issues, which raises vulnerabilities and adverse health outcomes (Fried et al., 2001; Pel-Littel, Schuurmans, Emmelot-Vonk, & Verhaar, 2009). The outcomes of frailty are usually known as disability, functional impairment, incidence of hospitalization, and death. However, a concept of frailty is full of “known unknowns” such as which mechanism leads to frailty and how it is best managed and

Reported Edmonton Frail Scale (REFS). The REFS derived from the Edmonton Frail Scale which defined frailty using the accumulation deficit model. The REFS evaluated ten domains for screening cognition function, general health status, functional independence, social support, medication uses, nutrition, mood, incontinence, self-reported performance. A total REFS score is 18, the scores of 12–18 is severe frailty, score 10–11 is moderate frailty, scores 8–9 is mild frailty, scores 6–7 is apparently frail and scores 0–5 is non-frail (Hilmer et al.,

Shared frailty models explain correlations within groups (family, litter or clinic) or for recurrent events facing the same individual. i.e., the different events within each community share a common frailty, shared by each individual within the community and each unit belongs to precisely one category. The shared gamma frailty model was suggested by Clayton (1978) for the analysis of the correlation between clustered survival times in genetic epidemiology.

To deal with the complexity of frailty in clinical settings, screening who are truly frail with an effectively instrument is significance. Several concepts of frailty have been established to detect frail status. Various assessment instruments also have been developed and widely translated to assess frail status. The most common components of frailty assessment were physical performance, physical activity, fatigue, cognitive function, weight loss, and comorbidity. Current evidence shows that individual factors and individual behavior factors may lead to the different rate of progression of frailty. Thus, translating frailty screening—the Thai version—with considering for individual factors and cultural context will make a shift to the precision

The aim of this program is to enhance the elderly wellbeing, by sharpening their senses, built self-esteem, and establishes good social relations. Aadlandsvik, R., (2007). Valentino, E., (2016) research showed that dance movement therapy improved balance, mood, social interaction and the energy level of the elderly with neurological damage. While there is a necessity for such a program, no one life should be at risk and so due diligence will be given to this aspect of the program. Mcdermott, A., Mernitz, H., Mayer, J., (2014) cautioned that in undertaking any exercise program for the older adult this will require medical clearance and regular, scheduled follow up. They advised that adhere to the American College of Sports Medicine's assessment guideline, the medical and trained exercise professionals could determine the