Are healthy ageing trajectories suitable to identify rehabilitation needs of the ageing population? An exploratory study using ATHLOS cohort data.

Background: The ageing process is highly heterogeneous leading to diverse ageing trajectories. Such trajectories have been modelled to study trends and determinants of ageing and could potentially be used to inform the planning of rehabilitation services at population level. The objective of this paper was to explore whether healthy ageing trajectories are suitable to identify targets for rehabilitation interventions for the ageing population.

Frailty detection in older adults via fractal analysis of acceleration signals from wrist-worn sensors.

Purpose: Frailty is a reversible multidimensional syndrome that puts older people at a high risk of adverse health outcomes. It has been proposed to emerge from the dysregulation of the complex system dynamics of physiologic control systems. We propose the analysis of the fractal complexity of hand movements as a new method to detect frailty in older adults.

Differential utility of various frailty diagnostic tools in non-geriatric hospital departments of several countries: A longitudinal study.

Background: There is limited knowledge on the performance of different frailty scales in clinical settings. We sought to evaluate in non-geriatric hospital departments the feasibility, agreement and predictive ability for adverse events after 1 year follow-up of several frailty assessment tools.

Methods: Longitudinal study with 667 older adults recruited from five hospitals in three different countries (Spain, Italy and United Kingdom).

Predictors of Maintained Transitions Between Robustness and Prefrailty in Community-Dwelling Older Spaniards.

Objectives: We aimed to explore predictors of sustained transitions (those that are maintained for an extra follow-up) between robustness and prefrailty in both directions.

Design: Longitudinal population-based cohort.

Setting And Participants: Community-dwelling Spaniards 65 years or older from the Toledo Study of Healthy Ageing.

Differential Association of Frailty and Sarcopenia With Mortality and Disability: Insight Supporting Clinical Subtypes of Frailty.

Objectives: Sarcopenia and frailty have been shown separately to predict disability and death in old age. Our aim was to determine if sarcopenia may modify the prognosis of frailty regarding both mortality and disability, raising the existence of clinical subtypes of frailty depending on the presence of sarcopenia.

Design: A Spanish longitudinal population-based study.

The ability of eight frailty instruments to identify adverse outcomes across different settings: the FRAILTOOLS project.

Background: To compare the performance of eight frailty instruments to identify relevant adverse outcomes for older people across different settings over a 12 month follow-up.

Methods: Observational longitudinal prospective study of people aged 75 + years enrolled in different settings (acute geriatric wards, geriatric clinic, primary care clinics, and nursing homes) across five European cities. Frailty was assessed using the following: Frailty Phenotype, SHARE-FI, 5-item Frailty Trait Scale (FTS-5), 3-item FTS (FTS-3), FRAIL scale, 35-item Frailty Index (FI-35), Gérontopôle Frailty Screening Tool, and Clinical Frailty Scale.

Early identification of frailty: Developing an international delphi consensus on pre-frailty.

Background: Frailty is associated with a prodromal stage called pre-frailty, a potentially reversible and highly prevalent intermediate state before frailty becomes established. Despite being widely-used in the literature and increasingly in clinical practice, it is poorly understood.

Objective: To establish consensus on the construct and approaches to diagnose and manage pre-frailty.

[Advantage, a joint action to face up to frailty.].

The European Commission and 22 European Union Member States cofounded the first Joint Action (JA) in frailty: ADVANTAGE. It aimed to build a common framework to push frailty as a public health priority contributing to a homogeneous and evidence-based approach across Europe. This article details how the JA has evolved and its main results, especially in Spain where the Roadmap to Approach Frailty was developed within the Strategy of Health Promotion and Prevention of the National Health System and approved by the Public Health Commission on 14/11/2019.

Transitions Between Frailty States and Its Predictors in a Cohort of Community-Dwelling Spaniards.

Objectives: Study the frequency and determinants of frailty transitions in a community-dwelling older population.

Design: Population-based prospective longitudinal study [The Toledo Study of Healthy Ageing (TSHA)].

Setting And Participants: 1748 community-dwelling individuals aged >65 years living in Toledo, a Spanish province.

The Structural and Intercultural Competence for Epidemiological Studies (SICES) guidelines: a 22-item checklist.

Structural and intercultural competence approaches have been widely applied to fields such as medical training, healthcare practice, healthcare policies and health promotion. Nevertheless, their systematic implementation in epidemiological research is absent. Based on a scoping review and a qualitative analysis, in this article we propose a checklist to assess cultural and structural competence in epidemiological research: the Structural and Intercultural Competence for Epidemiological Studies guidelines.

Relationship between self-reported visual impairment and worsening frailty transition states in older people: a longitudinal study.

Background: Visual impairment (VI) may lead to worsening functional status and disability. Although disability is very difficult to reverse, it is usually preceded by frailty that may be reverted more easily. It is possible that VI is also related to frailty.

A Comparison of Frailty Assessment Instruments in Different Clinical and Social Care Settings: The Frailtools Project.

Objective: To determine which of 8 commonly employed frailty assessment tools demonstrate the most appropriate characteristics to be employed in different clinical and social settings.

Design: Cross-sectional multicenter European-based study.

Setting And Participants: 1440 patients aged ≥75 years evaluated in geriatric inpatient wards, geriatric outpatient clinics, primary care clinics, and nursing homes.

The Disease Burden Morbidity Assessment in older adults and its association with mortality and other health outcomes.

The objective of this study was to assess how disease burden caused by chronic conditions is related to mortality (predictive validity) and other health outcomes (convergent validity). This was studied in 625 community-dwelling adults living in Spain aged 65 years and older. Disease burden was measured with the Disease Burden Morbidity Assessment (DBMA).

Incidence of frailty: a systematic review of scientific literature from a public health perspective.

Introduction: Because of the dynamic nature of frailty, prospective epidemiological data are essential to calibrate an adequate public health response.

Methods: A systematic review of literature on frailty incidence was conducted within the European Joint Action ADVANTAGE.

Results: Of the 6 studies included, only 3 were specifically aimed at estimating frailty incidence, and only 2 provided disaggregated results by at least gender.

Rasch Analysis and Construct Validity of the Disease Burden Morbidity Assessment in Older Adults.

Purpose Of The Study: The Disease Burden Morbidity Assessment (DBMA) is a self-report questionnaire in which participants rate the disease burden caused by a number of medical conditions. This paper studies the measurement properties of the DBMA, using Rasch analysis.

Design And Methods: We used data of 1,400 community-dwelling adults aged 50 years and older participating in the Ageing in Spain Longitudinal Study, Pilot Survey (ELES-PS).

Integrated Care: A Collaborative ADVANTAGE for Frailty.

Frailty is increasingly recognised as a public health priority due to the associated demand for acute and longer term health and social care support, and the impact on the lives of individuals, caregivers and families. Integrated care is widely considered to be most effective when applied to an older population, but there is limited data on outcomes and costs from studies of integrated care to prevent and manage frailty. This paper describes work by the ADVANTAGE Joint Action (JA), co-funded by the European Union and 22 Member States, to develop a common European approach to the prevention and management of frailty.