Diagnose- und Screening-Instrumente der Frailty bei älteren Menschen

T. Braun; C. Thiel; C. Grüneberg

doi:10.1055/s-0035-1567135

physioscience 2016; 12(04): 142-151
DOI: 10.1055/s-0035-1567135

Originalarbeit

Diagnose- und Screening-Instrumente der Frailty bei älteren Menschen

Übersicht systematischer ReviewsDiagnostic and Screening Tools for Frailty in Older PeopleOverview of Systematic Reviews

T. Braun

,

C. Thiel

,

C. Grüneberg

Abstract

Zusammenfassung

Hintergrund: Frailty (Gebrechlichkeit) ist durch eine reduzierte Reserve und verminderte Abwehrfähigkeit von Stressoren charakterisiert. Sie beschreibt den vulnerablen Zustand älterer Menschen für negative Gesundheitsereignisse. Die Diagnostik von Frailty ist wichtig, um betroffenen Personen eine angepasste Versorgung zukommen zu lassen.

Ziel: Die vorliegende Übersichtsarbeit stellt wichtige Diagnose- und Screening-Instrumente der Frailty anhand internationaler Reviews dar.

Methode: Die systematische Literaturrecherche anhand der Datenbank MEDLINE schloss ausschließlich systematische Reviews ein, die die Gütekriterien von Diagnose- und Screening-Instrumenten der Frailty analysierten. Die Verfügbarkeit deutschsprachiger Testversionen wird dargestellt.

Ergebnisse: Die insgesamt eingeschlossenen 6 Reviews beschreiben, dass die Gütekriterien der meisten Messinstrumente nicht ausführlich untersucht wurden und daher unklar bleiben. Der Frailty Phänotyp (Frailty als physisches Syndrom) und der Frailty Index (Akkumulation von Defiziten) sind gängige Modelle zur Definition und Diagnosestellung von Frailty. Als Screening-Instrumente der Frailty mit den besten Gütekriterien gelten momentan die Gehgeschwindigkeit, der Timed-up-and-go-Test, der PRISMA-7 Fragebogen, der Tilburg Frailty Indicator sowie das SHARE-Frailty Instrument. Für das Screening im klinischen Alltag scheint ein zweistufiger Prozess nötig.

Schlussfolgerungen: Die vorliegende Übersichtsarbeit bietet eine umfassende Übersicht der verfügbaren Diagnose- und Screening-Instrumente der Frailty. Deutschsprachige Versionen der Messinstrumente werden bereitgestellt oder auf ihre entsprechenden Quellen verwiesen.

Abstract

Background: Frailty is characterised by a reduced reserve and decreased resistance to stressors. It describes a state of high vulnerability of older individuals towards negative health outcomes. Diagnosis of frailty is important to provide frail older people with appropriate care.

Object: The aim of this review was to describe diagnostic tools and screening instruments of frailty based on international reviews.

Method: This systematic literature research using the MEDLINE database included only systematic reviews that analysed the quality criteria of frailty diagnostic and screening tools. The availability of German-language test versions is described.

Results: The included 6 reviews report that the quality criteria of most instruments have not been evaluated extensively and therefore remain unclear. The frailty phenotype (frailty as physical syndrome) and the frailty index (accumulation of deficits) are prevalent models for the definition and assessment of frailty. Gait speed, the timed-up-and-go test, the PRISMA-7 questionnaire, the Tilburg Frailty Indicator and the SHARE-Frailty Instrument are considered as frailty screening tools implementing the best quality criteria.

Conclusions: This review provides a comprehensive overview of the available diagnosis and screening tools for frailty. German-language versions of these assessment tools are provided or referred to their concordant references.

Schlüsselwörter

Frailty - Diagnose - Screening - Frailty Phänotyp - Frailty Index - geriatrisches Assessment

Key words

frailty - diagnosis - screening - frailty phenotype - frailty index - geriatric assessment

Volltext

Referenzen

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