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Frailty-Diagnose als Ausgangspunkt einer Trainingsintervention

Diagnosis of frailty as starting point for training interventions

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Zusammenfassung

Durch das Konzept von Frailty wird eine ältere Risikopopulation beschrieben, die eine erhöhte Wahrscheinlichkeit für das Auftreten negativer Gesundheitsereignisse aufweist. Aus gesellschaftlicher und auch aus individueller Sicht erscheint es erstrebenswert, die Prognose dieser Menschen durch gezielte Interventionen zu verbessern. Zwischenzeitlich liegt eine Reihe von systematischen Übersichtsarbeiten und Metaanalysen vor, die ganz unterschiedliche Interventionen vergleichen. Diese Arbeiten kommen zu dem Schluss, dass Trainingsinterventionen die besten Effekte erzielen. Gruppenangebote scheinen effektiver zu sein als Trainingsprogramme, die (teilweise) im häuslichen Setting absolviert werden. Das „case finding“ für solche Interventionen sollte mithilfe von Frailty-Instrumenten erfolgen, die auf Kraft, Ausdauer und/oder körperliche Aktivität fokussiert. Hier eignen sich insbesondere die Frailty-Kriterien nach Fried oder aber das Gehtempo und die Short Physical Performance Battery (SPPB). Ein flächendeckendes Angebot entsprechender Trainingsgruppen erscheint aus geriatrischer Sicht dringend erforderlich. Die Umsetzung erfordert jedoch einen deutlichen Ausbau bestehender Strukturen und neue Wege, um ältere Menschen mit Frailty zu erreichen.

Abstract

The concept of frailty describes an older at-risk population, which has a higher probability for the occurrence of unfavorable health outcomes. It is in the interest of frail individuals as well as the healthcare system to improve the prognosis of these people by targeted interventions. Several systematic reviews and meta-analyses are now available comparing very different interventions in frail older adults. These studies came to the conclusion that training interventions were found to be the most effective. Compared to exercise interventions delivered at participants homes, exercise in groups was found to be more effective. The case finding for such interventions should be carried out with frailty instruments that focus on strength, endurance and/or physical activity. Particularly suitable for this are the frailty criteria of Fried, gait speed or the short physical performance battery (SPPB). From a geriatrics perspective, a comprehensive offer of group training seems to be urgently necessary; however, the implementation requires a large expansion of existing structures and new ways to reach older people with frailty.

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Authors and Affiliations

  1. Geriatrisches Zentrum, Universitätsklinikum Heidelberg, Agaplesion Bethanien Krankenhaus Heidelberg, Rohrbacher Str. 149, 69126, Heidelberg, Deutschland

    Petra Benzinger & Jürgen Bauer

  2. Institut für Gesundheit und Generationen, Fakultät Soziales und Gesundheit, Hochschule für Angewandte Wissenschaften Kempten, Bahnhofstr. 61, Kempten, Deutschland

    Petra Benzinger

  3. Abteilung für Geriatrie, Robert-Bosch-Krankenhaus, Auerbachstr. 110, 70376, Stuttgart, Deutschland

    Kilian Rapp

Authors
  1. Petra Benzinger
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  2. Kilian Rapp
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  3. Jürgen Bauer
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Correspondence to Petra Benzinger.

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Interessenkonflikt

P. Benzinger, K. Rapp und J. Bauer geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Benzinger, P., Rapp, K. & Bauer, J. Frailty-Diagnose als Ausgangspunkt einer Trainingsintervention. Z Gerontol Geriat 55, 650–654 (2022). https://doi.org/10.1007/s00391-022-02113-8

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