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Frailty
: Update on Diagnosis Evaluation and Management
Part 2
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Abdulrazak
Abyad (1)
Sonia Ouali Hammami (2)
(1) CEO, Abyad
Medical Center, Lebanon.
Chairman, Middle-East Academy for Medicine of
Aging,. President, Middle East & North Africa
Association on Aging & Alzheimer’s, Coordinator,
Middle-East Primary Care Research Network
Coordinator, Middle-East Network on Aging,
(2) Internal Medicine Department-Endocrinology,
Geriatric Unit, CHU F Bourguiba Monastir,
Research Lab : Human Nutrition & metabolic
disorder, University of Monastir, Tunisia
Corresponding author:
Dr Abdulrazak Abyad,
Email: aabyad@cyberia.net.lb; amcmeli@gmail.com
Corresonding author:Received
April 2021. Accepted May 2021. Published June
1, 2021.Please cite this article as: Abdulrazak
Abyad, Sonia Ouali Hammammi. Frailty: Update on
Diagnosis Evaluation and Management -Part 1. Middle
East J Intern Med 2021; 14(1): 26-34. DOI: 10.5742/MEJIM2021.93795
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ABSTRACT
Life expectancy continues to
rise globally. However, the additional years of
life do not always correspond to years of healthy
life, which may result in an increase in frailty.
Given the rapid aging of the population, the association
between frailty and age, and the impact of frailty
on adverse outcomes for older adults, frailty
is increasingly recognized as a significant public
health concern. Early detection of the condition
is critical for assisting older adults in regaining
function and avoiding the negative consequences
associated with the syndrome. Despite the critical
nature of frailty diagnosis, there is no conclusive
evidence or consensus regarding whether routine
screening should be implemented. A variety of
screening and assessment instruments have been
developed from a biopsychosocial perspective,
with frailty defined as a dynamic state caused
by deficits in any of the physical, psychological,
or social domains associated with health. All
of these aspects of frailty should be identified
and addressed through the use of a comprehensive
and integrated approach to care. To accomplish
this goal, public health and primary health care
(PHC) must serve as the fulcrum around which care
is delivered, not just to the elderly and frail,
but to all individuals, by emphasizing a life-course
and patient-centered approach centered on integrated,
community-based care. Personnel in public health
should be trained to address frailty not just
clinically, but also in a societal context. Interventions
should take place in the contextof the individuals’
environment and social networks.
Additionally, public health professionals should
contribute to community-based frailty education
and training, promoting community-based interventions
that assist older adults and their caregivers
in preventing and managing frailty. The purpose
of this paper is to provide an overview of frailty
for a public health audience in order to increase
awareness of the multidimensional nature of frailty
and how it should be addressed through an integrated
and holistic approach to care.
Key words: Frailty,
diagnosis, evaluation, management
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