Evidence-Based Approaches in the Prevention and Management of Frailty in the Elderly

Year 2023, Volume: 13 Issue: 3, 501 - 507, 21.09.2023

Ayşe Buket Doğan , Özlem Canbolat

https://doi.org/10.33631/sabd.1110895

Abstract

Frailty “A medical syndrome with multiple causes and contributing factors, characterized by decreased strength, stamina, and decreased physiological function, increasing an individual's increased dependence and vulnerability to death.” is defined as. It is seen that there is an increase in the incidence of fragility with the rapid increase in the elderly population. For this reason, minimizing biological, sociological, economic and environmental stress factors in order to reduce or prevent frailty, especially in elderly individuals, comprehensive geriatric evaluation of elderly individuals, early diagnosis of diseases and interventions to prevent fragility constitute the main objective of fragility management. Frail elderly individuals are at risk for rehospitalization, falls, mortality and morbidity. Experts are of the opinion that, through interventions, vulnerability can be prevented or its emerging effects can be weakened. Methods with proven efficacy include mainly physical activity, nutritional interventions, prevention of polypharmacy, improvement of social environment, and routine frailty screening of older individuals with an approved screening method. In this review, research on the prevention and management of frailty and the level of evidence for frailty guidelines are reviewed.

Keywords

Frailty, aged, prevention of frailty, evidence-based nursing.

Yaşlılarda Kırılganlığın Önlenmesi ve Yönetiminde Kanıta Dayalı Yaklaşımlar

Abstract

Kırılganlık “Bireyin artan bağımlılığını ve ölüme karşı savunmasızlığını artıran, azalan güç, dayanıklılık ve azalmış fizyolojik işlev ile karakterize edilen, birden çok nedeni ve katkıda bulunan faktörleri olan tıbbi bir sendrom.” olarak tanımlanmaktadır. Yaşlı nüfusun hızla artması ile kırılganlık insidansında da artış olduğu görülmektedir. Bu sebeple özellikle yaşlı bireylerde kırılganlığın azaltılması veya önlenmesi için biyolojik, sosyolojik, ekonomik ve çevresel stres faktörlerinin en aza indirilmesi, yaşlı bireylere kapsamlı geriatrik değerlendirme yapılması, hastalıklarda erken tanı konulması ve kırılganlığı önleyecek müdahalelerde bulunulması kırılganlık yönetiminin temel hedefini oluşturmaktadır. Kırılgan yaşlı bireyler yeniden hastaneye yatış, düşme, mortalite ve morbidite açısından risk altındadır. Uzmanlar yapılacak müdahaleler sayesinde kırılganlığın engellenebileceği veya ortaya çıkan etkilerinin zayıflatılabileceği görüşündedir. Etkinliği kanıtlanmış yöntemler arasında başlıca fiziksel aktivite, beslenme müdahaleleri, polifarmasinin önlenmesi, sosyal ortamın iyileştirilmesi ve yaşlı bireylere rutin olarak onaylanmış bir tarama yöntemi ile kırılganlık taraması yapılması gelmektedir. Bu derleme yazının amacı kırılganlığın önlenmesi ve yönetimi ile ilgili yapılan araştırmaları ve kırılganlık ile ilgili kılavuzların kanıt seviyelerinin incelenmesidir.

Keywords

Kırılganlık, yaşlı, kanıta dayalı hemşirelik

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