New Frailty CPG Recommendations Released
Experts on frailty from 13 countries around the world have convened to develop clinical practice guideline (CPG) recommendations for the management of frailty, published in the July issue of JAMDA.
Frailty is defined as “a reduced strength and physiologic malfunctioning that increases an individual’s susceptibility to increased dependency, vulnerability, and death” by the International Association of Gerontology and Geriatrics Frailty Consensus. In “The Asia –Pacific Clinical Practice Guidelines for the Management of Frailty,” the researchers highlight the needs for CPG recommendations specific to frailty, which include: to provide evidence-based information to providers; to help health care providers better recognize and manage frailty; and to improve quality of life and outcomes for those living with frailty.
The participants grouped CPG recommendations into categories of “strong,” “conditional,” and “no recommendation.” Each category refers directly to the strength of its supporting evidence base, as outlined below.
- Use a validated measurement tool to identify frailty;
- Prescribe physical activity with a resistance training component;
- Address polypharmacy by reducing or deprescribing any inappropriate/superfluous medications
- Screen for, and address modifiable causes of fatigue;
- For persons exhibiting unintentional weight loss, screen for reversible causes and consider food fortification and protein caloric supplementation;
- Prescribe vitamin D for individuals deficient in vitamin D.
No recommendation was given regarding the provision of a patient support and education plan.
These CPG recommendations were developed using an adapted Grading of Recommendations, Assessment, Development and Evaluation method, which included an evaluation of current evidence paired with evaluations from an international multidisciplinary clinical expert panel.
The researchers designed the frailty CPGs to be concise and condensed to encourage use by health care professionals. John Morley, MD, MCh, JAMDA Editor-in-Chief, as well as a researcher for this study, says, “As the number of people becoming ‘elderly’ is quickly rising across the world every day, so is the prevalence of frailty. This is a global health issue. It is imperative to a patient’s health that frailty is properly identified. We believe these CPG recommendations will help with recognition and management of frailty, and in turn, overall quality of life.”